| NPI | 1073172037 |
|---|---|
| Former Name | BRENNAN ALLEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AZ D010405) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 11381) |
| Enumeration Date | 2019-06-12 |
| Last Update Date | 2026-01-28 |