Provider Demographics
NPI:1770683054
Name:BRENDER, DENNIS (DDS)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:
Last Name:BRENDER
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 1:507 W 15TH ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-1511
Mailing Address - Country:US
Mailing Address - Phone:512-478-4411
Mailing Address - Fax:512-478-0069
Practice Address - Street 1:507 W 15TH ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-1511
Practice Address - Country:US
Practice Address - Phone:512-478-4411
Practice Address - Fax:512-478-0069
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14025122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist