Provider Demographics
NPI:1871518142
Name:MCLAUGHLIN, BRENDAN T (DDS)
Entity type:Individual
Prefix:DR
First Name:BRENDAN
Middle Name:T
Last Name:MCLAUGHLIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453-5539
Mailing Address - Country:US
Mailing Address - Phone:978-840-3366
Mailing Address - Fax:978-840-3351
Practice Address - Street 1:96 MAIN ST
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-5539
Practice Address - Country:US
Practice Address - Phone:978-840-3366
Practice Address - Fax:978-840-3351
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA200481223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics