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General NPI Number Information
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NPI Number | 1124668488
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Entity Type | Individual
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Provider Name | DEBORAH L BRIMMER DENTAL HYGIENIST
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Gender | Female
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Dates
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Enumeration Date | 01/14/2020
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Last Update Date | 01/14/2020
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Provider Practice Location Address
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Address Line | 5801 DEFENSE PENTAGON
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City | WASHINGTON
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State | DC
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Zip | 20310
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Country | US
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Telephone | 703-692-8701
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Fax |
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Provider Business Mailing Address
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Address Line | PENTAGON DENTAL CLINIC 5801 DEFENSE PENTAGON
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City | WASHINGTON
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State | DC
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Zip | 20310
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Country | US
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Telephone | 407-760-0869
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | DH16749
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License Number State | FL
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