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NPI Code Detail

MEDICARE: DR. JASON JOSEPH BREZOVIC DMD

MEDICARE:  DR. JASON JOSEPH BREZOVIC  DMD
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
1122300000XDentistDS037433PA

General Provider Information

NPI Number : 1447423660
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JASON JOSEPH BREZOVIC DMD
Provider Business Mailing Address
First Line : 1647 TAUSSIG BLVD
Second Line :
City : NORFOLK
State : VA
Zip : 23511-2896
Country : US
Telephone Number : 757-953-8547
Fax Number :
Provider Business Practice Location Address
First Line : 1647 TAUSSIG BLVD
Second Line :
City : NORFOLK
State : VA
Zip : 23511-2896
Country : US
Telephone Number : 757-953-8547
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2008
Last Update Date : 04/09/2008

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Directions to “ DR. JASON JOSEPH BREZOVIC DMD” Practice Location

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