Provider Demographics
NPI:1750654117
Name:BURWELL, BRITTANY ANN (DMD)
Entity Type:Individual
Prefix:DR
First Name:BRITTANY
Middle Name:ANN
Last Name:BURWELL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12221 DETROIT AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-3020
Mailing Address - Country:US
Mailing Address - Phone:248-765-4152
Mailing Address - Fax:
Practice Address - Street 1:3976 KING GRAVES RD
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:OH
Practice Address - Zip Code:44473-6900
Practice Address - Country:US
Practice Address - Phone:330-609-1859
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-15
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0249861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice