Organization
ERIC W. BRUST DDS PC
Active
Organization
ERIC W. BRUST DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERIC W BRUST DDS MS (OWNER)
(313) 299-9700
Entity
Organization
Contact information
Practice address
10460 PELHAM RD, TAYLOR, MI 48180-3828
(313) 299-9700
(313) 299-9951
Mailing address
10460 PELHAM RD, TAYLOR, MI 48180-3828
(313) 299-9700
(313) 299-9951
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
15547
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
123042560
CSHCS
MI
01
—
193998
UNITED CONCORDIA
MI
Enumeration date
11/14/2006
Last updated
10/22/2014
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