Provider Demographics
NPI:1417785593
Name:OLEJNIK-BRZUSEK, ROBERT ADAM (DDS)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:ADAM
Last Name:OLEJNIK-BRZUSEK
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 1:2891 E MAPLE RD
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-6106
Mailing Address - Country:US
Mailing Address - Phone:248-689-1343
Mailing Address - Fax:
Practice Address - Street 1:1140 S BELSAY RD
Practice Address - Street 2:
Practice Address - City:BURTON
Practice Address - State:MI
Practice Address - Zip Code:48509-1909
Practice Address - Country:US
Practice Address - Phone:810-744-0433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-22
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901602225122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist