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General NPI Number Information
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NPI Number | 1093073322
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Entity Type | Individual
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Provider Name | BRENTON ASSING D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 04/24/2012
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Last Update Date | 08/11/2015
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Provider Practice Location Address
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Address Line | 719 W ROBERTSON ST
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City | BRANDON
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State | FL
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Zip | 33511-4921
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Country | US
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Telephone | 813-685-6139
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Fax |
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Provider Business Mailing Address
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Address Line | 5503 BRANCH OAK PL
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City | LITHIA
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State | FL
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Zip | 33547-4801
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | DN 21514
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License Number State | FL
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