Provider Demographics
NPI:1871107177
Name:YOUNG, BRITTANY JANAE (DDS)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:JANAE
Last Name:YOUNG
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 1:22016 PATCH LAKE RD
Mailing Address - Street 2:
Mailing Address - City:COLD SPRING
Mailing Address - State:MN
Mailing Address - Zip Code:56320-8735
Mailing Address - Country:US
Mailing Address - Phone:320-469-6907
Mailing Address - Fax:
Practice Address - Street 1:106 E JAMES ST
Practice Address - Street 2:
Practice Address - City:PAYNESVILLE
Practice Address - State:MN
Practice Address - Zip Code:56362-1615
Practice Address - Country:US
Practice Address - Phone:320-243-4434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-03
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND144851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice