MEDICARE: BRIAN REZEL CARR DMD MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	600129215	WI

General Provider Information

NPI Number	:	1093270217
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN REZEL CARR DMD MD

Provider Business Mailing Address
First Line	:	7801 S HOWELL AVE STE 202
Second Line	:
City	:	OAK CREEK
State	:	WI
Zip	:	53154-7117
Country	:	US
Telephone Number	:	414-764-2880
Fax Number	:

Provider Business Practice Location Address
First Line	:	7801 S HOWELL AVE STE 202
Second Line	:
City	:	OAK CREEK
State	:	WI
Zip	:	53154-7117
Country	:	US
Telephone Number	:	414-764-2880
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/01/2019
Last Update Date	:	05/20/2025

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