Provider Demographics
NPI:1225227044
Name:BREWICK, TERRY L (DDS)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:L
Last Name:BREWICK
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 1:6920 E 23RD AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80207-4080
Mailing Address - Country:US
Mailing Address - Phone:303-531-1578
Mailing Address - Fax:720-443-4035
Practice Address - Street 1:6920 E 23RD AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80207-4080
Practice Address - Country:US
Practice Address - Phone:303-531-1578
Practice Address - Fax:720-443-4035
Is Sole Proprietor?:No
Enumeration Date:2007-10-17
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO105046122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist