Provider Demographics
NPI:1518034164
Name:BRAJAK, ANA MARIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANA
Middle Name:MARIA
Last Name:BRAJAK
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38254 CHARWOOD DR
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48312-1225
Mailing Address - Country:US
Mailing Address - Phone:586-872-7272
Mailing Address - Fax:586-939-5742
Practice Address - Street 1:24901 KELLY RD
Practice Address - Street 2:
Practice Address - City:EASTPOINTE
Practice Address - State:MI
Practice Address - Zip Code:48021-1367
Practice Address - Country:US
Practice Address - Phone:586-772-2090
Practice Address - Fax:586-772-0742
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010191491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice