Provider Demographics
NPI:1336277425
Name:COONEY, BRENDAN MICHAEL (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:BRENDAN
Middle Name:MICHAEL
Last Name:COONEY
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Gender:M
Credentials:DDS, MS
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Mailing Address - Street 1:500 FEDERAL ST
Mailing Address - Street 2:SUITE 600
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12180-2832
Mailing Address - Country:US
Mailing Address - Phone:518-274-4322
Mailing Address - Fax:518-274-6059
Practice Address - Street 1:500 FEDERAL ST
Practice Address - Street 2:SUITE 600
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-2832
Practice Address - Country:US
Practice Address - Phone:518-274-4322
Practice Address - Fax:518-274-6059
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY0389431223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics