Provider Demographics
NPI:1861024861
Name:BRIAN K DENNIS DDS PC
Entity type:Organization
Organization Name:BRIAN K DENNIS DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:DENNIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:505-292-1051
Mailing Address - Street 1:8400 OSUNA RD NE STE 6A
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-2073
Mailing Address - Country:US
Mailing Address - Phone:505-292-1051
Mailing Address - Fax:
Practice Address - Street 1:8400 OSUNA RD NE STE 6A
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-2073
Practice Address - Country:US
Practice Address - Phone:505-292-1051
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-07
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty