Mark P Brieden, D.D.S., M.S.

Individual provider Active NPI Orthodontics and Dentofacial Orthopedics Dentistry · Rockford, MI

NPI 1285899484 · NPPES record last updated Jul 28, 2008

Key facts

NPI
1285899484
Entity type
Individual (NPI type 1)
Primary specialty
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X
License
MI 031950 (MI)
Practice address
158 Marcell Dr NE
Rockford, MI 49341-1390
Phone
(616) 866-3010
Fax
(616) 866-7401
NPI assigned
Jul 28, 2008
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
MI 031950MIMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Mark P. Brieden D.D.S., M.S., P.C. Orthodontics and Dentofacial Orthopedics Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X MI 031950 MI Yes

Addresses

Primary practice location

158 Marcell Dr NE
Rockford, MI 49341-1390

Mailing address

158 Marcell Dr NE
Rockford, MI 49341-1390
Phone (616) 866-3010

Other providers in Rockford, MI

All providers in Rockford, MI · Orthodontics and Dentofacial Orthopedics Dentistry in Michigan

Sources for this page

Verify at the official NPI Registry.