Dr. Brent S McClenny, DMD
Dentist, General Practice in Scott Air Force Base, IL. Individual provider (NPI-1).
NPI number1477548014
StatusActive
Last updated in NPPESJul 14, 2012
Details
- NPI
- 1477548014
- Entity type
- Individual (NPI-1)
- Name
- Dr. Brent S McClenny
- Credential
- DMD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 20, 2005
- Last updated
- Jul 14, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 3954 | AL | Yes |
Practice location
310 W Losey StScott Air Force Base, IL 62225-5250
Phone 618-256-3322
Mailing address
626 Quail RunO Fallon, IL 62269-3142
Phone 618-207-9694
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