Most Relevant Information
Provider Data
| NPI Number: | 1003815655 |
| Provider Name: | RANDY JAMES BREEN D.D.S. |
| Entity Type: | Individual |
| Taxonomy Code: | 1223G0001X |
| Specialty: | Dentist |
| License Number: | 2901014055 |
Most Important Dates
| Enumeration Date: | 07/17/2005 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
515 LAKESIDE DR SE
#208
GRAND RAPIDS
MI
495062931
Practice Location Phone/Fax
| Phone: | 6164549091 |
| Fax: | 6164541159 |
Provider Mailing Location
2435 ROLLING MEADOW DR NE
BELMONT
MI
493069332
Provider Mailing Phone/Fax
| Phone: | 6168639515 |
| Fax: |