Provider Demographics
NPI:1497846778
Name:BRITT, MICHAEL ROBERT (DDS MS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ROBERT
Last Name:BRITT
Suffix:
Gender:M
Credentials:DDS MS
Other - Prefix:
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Mailing Address - Street 1:4771 ROUNDTREE DR
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48116-5140
Mailing Address - Country:US
Mailing Address - Phone:313-300-5334
Mailing Address - Fax:810-229-6180
Practice Address - Street 1:4771 ROUNDTREE DR
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-5140
Practice Address - Country:US
Practice Address - Phone:313-300-5334
Practice Address - Fax:810-229-6180
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010103991223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics