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General NPI Number Information
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NPI Number | 1851920755
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Entity Type | Individual
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Provider Name | ALLYSON CHRISTINE BRENNAN DDS, MSD
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Gender | Female
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Dates
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Enumeration Date | 04/03/2020
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Last Update Date | 05/14/2024
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Provider Practice Location Address
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Address Line | 69 OLD TEMPLE HILL RD
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City | VAILS GATE
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State | NY
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Zip | 12584
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Country | US
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Telephone | 845-562-2063
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 512
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City | STORMVILLE
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State | NY
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Zip | 12582-0512
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 063069
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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