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General NPI Number Information
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NPI Number | 1306820600
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Entity Type | Individual
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Provider Name | DANIEL MICHAEL BRISKIE DDS
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Gender | Male
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Dates
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Enumeration Date | 12/01/2005
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Last Update Date | 12/23/2009
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Provider Practice Location Address
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Address Line | 1814 S ROCHESTER RD
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City | ROCHESTER HILLS
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State | MI
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Zip | 48307-3532
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Country | US
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Telephone | 248-608-2626
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Fax | 248-608-8149
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Provider Business Mailing Address
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Address Line | 1411 BUSH CREEK DR
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City | GRAND BLANC
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State | MI
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Zip | 48439-2306
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Country | US
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Telephone | 810-694-4580
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Fax | 810-694-4580
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 14206
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License Number State | MI
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