Healthcare Provider Details

I. General information

NPI: 1639643539
Provider Name (Legal Business Name): DR. MILENA BREZO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/14/2019
Last Update Date: 11/14/2023
Certification Date: 11/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7150 LEETSDALE DR
DENVER CO
80224-1999
US

IV. Provider business mailing address

7150 LEETSDALE DR # 110
DENVER CO
80224-1999
US

V. Phone/Fax

Practice location:
  • Phone: 720-230-0770
  • Fax:
Mailing address:
  • Phone: 720-933-0657
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDEN00204246
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2901022914
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: