Provider Demographics
NPI:1073969994
Name:BRINZEIU, OVIDIU (DDS)
Entity Type:Individual
Prefix:DR
First Name:OVIDIU
Middle Name:
Last Name:BRINZEIU
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23620 110TH AVE
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:MI
Mailing Address - Zip Code:49688-8637
Mailing Address - Country:US
Mailing Address - Phone:616-644-0811
Mailing Address - Fax:
Practice Address - Street 1:530 COBB ST
Practice Address - Street 2:
Practice Address - City:CADILLAC
Practice Address - State:MI
Practice Address - Zip Code:49601-2578
Practice Address - Country:US
Practice Address - Phone:616-644-0811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-10
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010217071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice