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General NPI Number Information
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NPI Number | 1093384463
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Entity Type | Individual
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Provider Name | BRANDON ROY RENTMEESTER DDS
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Gender | Male
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Dates
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Enumeration Date | 06/21/2021
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Last Update Date | 11/22/2024
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Provider Practice Location Address
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Address Line | 725 COUNTY ROAD R
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City | DENMARK
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State | WI
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Zip | 54208-8519
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Country | US
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Telephone | 920-863-2030
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Fax |
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Provider Business Mailing Address
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Address Line | 200 N JEFFERSON ST APT 2210
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City | CHICAGO
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State | IL
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Zip | 60661-1285
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Country | US
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Telephone | 920-621-1658
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 019.033233
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 600155315
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License Number State | WI
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