| Corey J Brenner Dds Pllc | |
|
9000 Walnut St Box 236 Rockford MN 55373-0236 | |
| (763) 477-5794 | |
| (763) 477-4784 |
| Full Name | Corey J Brenner Dds Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 9000 Walnut St, Rockford, Minnesota |
| Authorized Official Name and Position | Corey James Brenner (OWNER) |
| Authorized Official Contact | 7634775794 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Corey J Brenner Dds Pllc 8900 Walnut St Suite 450 Box 236 Rockford MN 55373-0236 Ph: (763) 477-5794 | Corey J Brenner Dds Pllc 9000 Walnut St Box 236 Rockford MN 55373-0236 Ph: (763) 477-5794 |
| NPI Number | 1689824898 |
|---|---|
| Provider Enumeration Date | 09/24/2008 |
| Last Update Date | 06/19/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689824898 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | D11525 (Minnesota) | Primary |
Holistic Roots Dentistry, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 9000 Walnut St, Rockford, MN 55373 Phone: 612-930-2591 |