Provider Demographics
NPI:1235255209
Name:CAREY, BRENT LEWIS (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRENT
Middle Name:LEWIS
Last Name:CAREY
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 1:32540 WARREN RD
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185-2910
Mailing Address - Country:US
Mailing Address - Phone:734-425-9130
Mailing Address - Fax:734-425-7675
Practice Address - Street 1:32540 WARREN RD
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-2910
Practice Address - Country:US
Practice Address - Phone:734-425-9130
Practice Address - Fax:734-425-7675
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901010645122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist