Provider Demographics
NPI:1952501835
Name:J. M. BRENNAN INC
Entity Type:Organization
Organization Name:J. M. BRENNAN INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MICHEAL
Authorized Official - Last Name:BRENNAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:330-733-7549
Mailing Address - Street 1:2020 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44312-1114
Mailing Address - Country:US
Mailing Address - Phone:330-733-7549
Mailing Address - Fax:330-733-5181
Practice Address - Street 1:2020 E MARKET ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44312-1114
Practice Address - Country:US
Practice Address - Phone:330-733-7549
Practice Address - Fax:330-733-5181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-19
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH18486122300000X
OH18955122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0678486Medicaid