Provider Demographics
NPI:1154440956
Name:BRENNAN, JOSEPH PAUL (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:PAUL
Last Name:BRENNAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 W AIRPORT HWY
Mailing Address - Street 2:P.O. BOX 270
Mailing Address - City:SWANTON
Mailing Address - State:OH
Mailing Address - Zip Code:43558-1441
Mailing Address - Country:US
Mailing Address - Phone:419-826-2525
Mailing Address - Fax:419-825-5067
Practice Address - Street 1:210 W AIRPORT HWY
Practice Address - Street 2:
Practice Address - City:SWANTON
Practice Address - State:OH
Practice Address - Zip Code:43558-1441
Practice Address - Country:US
Practice Address - Phone:419-826-2525
Practice Address - Fax:419-825-5067
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH217411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice