Provider Demographics
NPI:1932411204
Name:BRENDEN, AMANDA MAE (DDS)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:MAE
Last Name:BRENDEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2717 ORCHARD DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-5860
Mailing Address - Country:US
Mailing Address - Phone:319-266-7500
Mailing Address - Fax:319-277-5062
Practice Address - Street 1:2717 ORCHARD DR
Practice Address - Street 2:
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50613-5860
Practice Address - Country:US
Practice Address - Phone:319-266-7500
Practice Address - Fax:319-277-5062
Is Sole Proprietor?:No
Enumeration Date:2010-07-02
Last Update Date:2010-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA08717122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist