Most Relevant Information
Provider Data
| NPI Number: | 1003331174 |
| Provider Name: | MICHAEL NIKOLAY BEREZHKOV |
| Entity Type: | Individual |
| Taxonomy Code: | 126800000X |
| Specialty: | Dental Assistant |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/09/2017 |
| Last Updated: | 08/09/2017 |
Provider Practice Location
1 BOONE RD
BREMERTON
WA
983121894
Practice Location Phone/Fax
| Phone: | 4253044092 |
| Fax: |
Provider Mailing Location
1 BOONE RD
BREMERTON
WA
983121894
Provider Mailing Phone/Fax
| Phone: | 4253044092 |
| Fax: |