Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | DN18461 | FL |
NPI | 1043597214 |
---|---|
Provider Name | Dr. Christopher Drennen |
First Address | Hallandale, FL 33008 |
Second Address | Davie, FL 33330-4310 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2011 |
Last Update Date | 28/07/2020 |