Individual
DR. MICHAEL R. BREAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1368 UNION ST, SCHENECTADY, NY 12308-3017
(518) 374-4486
(518) 393-1612
Mailing address
1368 UNION ST, SCHENECTADY, NY 12308-3017
(518) 374-4486
(518) 393-1612
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
034453-1
NY
Other
Enumeration date
04/04/2007
Last updated
07/08/2007
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