Brenner Dental Group
Organization Active NPI Dental Clinic/Center · Buffalo, MN
NPI 1699190488 · NPPES record last updated Mar 3, 2014
Key facts
- NPI
- 1699190488
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dental Clinic/Center 261QD0000X
- License
- D11525 (MN)
- Legal business name
- BRENNER DENTAL GROUP
- Practice address
- 102 Marty Dr
Suite 3
Buffalo, MN 55313-9305 - Phone
- (763) 682-2101
- NPI assigned
- Mar 3, 2014
- Organization subpart
- No
Authorized official
- Name
- Dr. Corey J Brenner, DDS
- Title
- Owner
- Phone
- (612) 819-1223
Corporate family (same tax ID) 1
Practitioners 1
-
Nicole Leigh Tripp, D.D.S.
National Provider Directory
- Tax ID family
- Brenner Dental Group
Locations
102 Marty Dr
Ste 3
Buffalo, MN 55313
Phone (763) 682-2101
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Clinic/Center | 261QD0000X | D11525 | MN | Yes |
Addresses
Primary practice location
102 Marty Dr
Suite 3
Buffalo, MN 55313-9305
Mailing address
102 Marty Dr
Suite 3
Buffalo, MN 55313-9305
Phone (763) 682-2101
Other names
- Buffalo Dental Clinic
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All providers in Buffalo, MN · Dental Clinic/Center in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 3, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.