Provider Demographics
NPI:1205005170
Name:DR PAUL F BRECHT & JEFFREY T BAKER DDS PLLC
Entity Type:Organization
Organization Name:DR PAUL F BRECHT & JEFFREY T BAKER DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:T
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:586-992-9222
Mailing Address - Street 1:8152 25 MILE RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48316
Mailing Address - Country:US
Mailing Address - Phone:586-992-9222
Mailing Address - Fax:586-992-0814
Practice Address - Street 1:8152 25 MILE RD
Practice Address - Street 2:SUITE C
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48316
Practice Address - Country:US
Practice Address - Phone:586-992-9222
Practice Address - Fax:586-992-0814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-26
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty