| Donald J. Brockriede, D.d.s., P.c. | |
|
3720 Huron St North Branch MI 48461-8117 | |
| (810) 688-3008 | |
| (810) 688-2429 |
| Full Name | Donald J. Brockriede, D.d.s., P.c. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 3720 Huron St, North Branch, Michigan |
| Authorized Official Name and Position | Donald Joe Brockriede (OFFICER) |
| Authorized Official Contact | 8106883008 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Donald J. Brockriede, D.d.s., P.c. Po Box 707 North Branch MI 48461-0707 Ph: (810) 688-3008 | Donald J. Brockriede, D.d.s., P.c. 3720 Huron St North Branch MI 48461-8117 Ph: (810) 688-3008 |
| NPI Number | 1598977795 |
|---|---|
| Provider Enumeration Date | 05/03/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598977795 | NPI | - | NPPES |
| D105430 | Other | MI | BCBS OF MICH. DENTAL PROV |
| 5446023 | Other | MI | BCBS MEDICAL PROVIDER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 2901010543 (Michigan) | Primary |
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