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General NPI Number Information
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NPI Number | 1164848552
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Entity Type | Organization
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Legal Business Name | BRENNAN HUGHES DMD A PROFESSIONAL COORPORATION
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Dates
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Enumeration Date | 03/10/2014
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Last Update Date | 09/08/2014
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Provider Practice Location Address
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Address Line | 18500 VIA PRINCESSA
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City | SANTA CLARITA
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State | CA
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Zip | 91387-8321
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Country | US
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Telephone | 661-298-1100
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Fax | 661-298-1108
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Provider Business Mailing Address
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Address Line | 18500 VIA PRINCESSA
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City | SANTA CLARITA
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State | CA
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Zip | 91387-8321
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Country | US
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Telephone | 661-298-1100
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Fax | 661-298-1108
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. SOLEDAD BOND
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Credential |
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Telephone | 661-298-1100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 39280
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 39280
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License Number State | CA
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