Healthcare Provider Details

I. General information

NPI: 1740211820
Provider Name (Legal Business Name): NATALYA A BREZDEN DDS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

G-6221 W PIERSON RD
FLUSHING MI
48433
US

IV. Provider business mailing address

G-6221 W PIERSON RD
FLUSHING MI
48433
US

V. Phone/Fax

Practice location:
  • Phone: 810-733-2700
  • Fax: 810-733-3638
Mailing address:
  • Phone: 810-733-2700
  • Fax: 810-733-3638

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number015432
License Number StateMI

VIII. Authorized Official

Name: NATALYA BREZDEN
Title or Position: OWNER
Credential: DDS
Phone: 810-733-2770