Provider Demographics
NPI:1750427357
Name:DENNIS, BRIAN K (DDS)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:K
Last Name:DENNIS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8400 OSUNA RD NE
Mailing Address - Street 2:SUITE 6A
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-2087
Mailing Address - Country:US
Mailing Address - Phone:505-292-1051
Mailing Address - Fax:505-298-3921
Practice Address - Street 1:8400 OSUNA RD NE
Practice Address - Street 2:SUITE 6A
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-2087
Practice Address - Country:US
Practice Address - Phone:505-292-1051
Practice Address - Fax:505-298-3921
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM15021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice