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Individual

DR. BRIAN THOMAS FOSSE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
162 N CAUSEWAY ST, NORTH MUSKEGON, MI 49445-3302
(231) 744-3700
Mailing address
162 N CAUSEWAY ST, NORTH MUSKEGON, MI 49445-3302
(231) 744-3700

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12044
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4048960
MI
Enumeration date
06/17/2005
Last updated
07/08/2007
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