Provider Demographics
NPI:1063563997
Name:TERAN, BRETT A (DDS)
Entity type:Individual
Prefix:DR
First Name:BRETT
Middle Name:A
Last Name:TERAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:513 KNOLLWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ORTONVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48462-8323
Mailing Address - Country:US
Mailing Address - Phone:248-343-6830
Mailing Address - Fax:
Practice Address - Street 1:113 E MAIN ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:MI
Practice Address - Zip Code:48433-2023
Practice Address - Country:US
Practice Address - Phone:810-659-4561
Practice Address - Fax:810-213-0216
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI019322122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist