Individual
BRIAN JOSEPH PUTMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
610 N. PINE RIVER ST., ITHACA, MI 48847
(989) 875-2888
(989) 875-4604
Mailing address
610 N. PINE RIVER ST., ITHACA, MI 48847
(989) 875-2888
(989) 875-4604
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901021388
MI
122300000X
Dentist
30-023756
OH
Other
Enumeration date
06/19/2012
Last updated
12/15/2015
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