Provider Demographics
NPI:1437159332
Name:UEECK, BRETT ALLEN (MD, DMD)
Entity Type:Individual
Prefix:DR
First Name:BRETT
Middle Name:ALLEN
Last Name:UEECK
Suffix:
Gender:M
Credentials:MD, DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2489
Mailing Address - Street 2:
Mailing Address - City:SANDPOINT
Mailing Address - State:ID
Mailing Address - Zip Code:83864-0915
Mailing Address - Country:US
Mailing Address - Phone:503-467-9014
Mailing Address - Fax:503-601-0569
Practice Address - Street 1:3909 ARCTIC BLVD STE 404
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-5769
Practice Address - Country:US
Practice Address - Phone:907-222-5052
Practice Address - Fax:907-222-5051
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-21
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDD5181OS204E00000X
AK120881204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery