Healthcare Provider Details

I. General information

NPI: 1730008301
Provider Name (Legal Business Name): BRIANNA BERTRAND CRDH
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

871 W OAKLAND PARK BLVD
WILTON MANORS FL
33311-1731
US

IV. Provider business mailing address

871 W OAKLAND PARK BLVD
WILTON MANORS FL
33311-1731
US

V. Phone/Fax

Practice location:
  • Phone: 954-567-7141
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberDH32550
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: