| Organization Name: | BRENT PENNINGTON DMD,LLC |
| NPI Number: | 1417054784 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BRENT PENNINGTON (DENTIST/OWNER) |
| Mailing Address: | 37 Gateway Business Park Dr Ringgold |
| State: | GA US |
| Postal Code: | 307367395 |
| Phone Number: | 7069352900 |
| Fax Number: | 7069352904 |
| NPI Enumeration Date: | 09/20/2006 |
| NPI Last Update Date: | 03/26/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | DN012927 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |