Healthcare Provider Details

I. General information

NPI: 1124702535
Provider Name (Legal Business Name): FRANK PAUL BRETTSCHNEIDER DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2023
Last Update Date: 06/14/2023
Certification Date: 06/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2837 STABLE DR STE A
KIMBALL MI
48074-1441
US

IV. Provider business mailing address

8454 LAKESHORE RD
BURTCHVILLE MI
48059-1329
US

V. Phone/Fax

Practice location:
  • Phone: 810-985-3301
  • Fax: 855-747-1702
Mailing address:
  • Phone: 810-434-0934
  • Fax: 855-747-1702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2901601792
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: