Provider Demographics
NPI:1144405127
Name:RENCHER, TRENT G (DMD, MSD)
Entity Type:Individual
Prefix:DR
First Name:TRENT
Middle Name:G
Last Name:RENCHER
Suffix:
Gender:M
Credentials:DMD, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21364 SKYRIDGE LN NE
Mailing Address - Street 2:
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370-8925
Mailing Address - Country:US
Mailing Address - Phone:360-697-6545
Mailing Address - Fax:
Practice Address - Street 1:21364 SKYRIDGE LN NE
Practice Address - Street 2:
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-8925
Practice Address - Country:US
Practice Address - Phone:360-697-6545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-08
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60301223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics