# CONVENIENT BR PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Distinctive Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033548201
- **Authorized official:** MRS. CHRISTINE R MASCHKE (ASST. TO GEN. MGR)
- **Authorized official phone:** (248) 542-9700

## Contact information

- **Practice address:** 2120 GRAND RIVER ANX, SUITE 100, BRIGHTON, MI 48114-7392
- **Practice address phone:** (810) 225-0022
- **Practice address fax:** (810) 225-0033
- **Mailing address:** 2120 GRAND RIVER ANX, SUITE 100, BRIGHTON, MI 48114-7392
- **Mailing address phone:** (810) 225-0022
- **Mailing address fax:** (810) 225-0033

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 2901019426 | MI | Yes |

## Other

- **Enumeration date:** 11/07/2013
- **Last updated:** 12/12/2014