Provider Demographics
NPI:1740479443
Name:PECK, BRIAN RICHARD (DMD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:RICHARD
Last Name:PECK
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1933 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95818-3827
Mailing Address - Country:US
Mailing Address - Phone:856-278-1546
Mailing Address - Fax:
Practice Address - Street 1:1933 5TH AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95818-3827
Practice Address - Country:US
Practice Address - Phone:856-278-1546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-18
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI01799000122300000X
CA110070122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist