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General NPI Number Information
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NPI Number | 1932356391
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Entity Type | Individual
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Provider Name | SANDRA R BRENER D.D.S
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Gender | Female
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Dates
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Enumeration Date | 08/27/2008
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Last Update Date | 03/03/2013
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Provider Practice Location Address
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Address Line | 9720 STIRLING RD SUITE 100
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City | HOLLYWOOD
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State | FL
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Zip | 33024-8013
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Country | US
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Telephone | 954-262-7500
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Fax |
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Provider Business Mailing Address
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Address Line | 11165 WHITEHAWK ST
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City | PLANTATION
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State | FL
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Zip | 33324-2175
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Country | US
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Telephone | 954-394-8996
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DN18599
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License Number State | FL
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