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General NPI Number Information
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NPI Number | 1124836473
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Entity Type | Individual
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Provider Name | EMILY MARIE BRENNAN RDH
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Gender | Female
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Dates
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Enumeration Date | 12/19/2024
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Last Update Date | 12/19/2024
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Provider Practice Location Address
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Address Line | 23076 THREE NOTCH RD STE 203
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City | CALIFORNIA
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State | MD
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Zip | 20619-2491
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Country | US
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Telephone | 240-349-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 23349 RED OAK CT
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City | CALIFORNIA
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State | MD
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Zip | 20619-4070
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Country | US
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Telephone | 240-561-3713
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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 | 8352
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License Number State | MD
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