Provider Demographics
NPI:1750872479
Name:SZYMANSKI, BRIANNA BEATRICE (DDS)
Entity type:Individual
Prefix:DR
First Name:BRIANNA
Middle Name:BEATRICE
Last Name:SZYMANSKI
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 1:414 BENSON AVE NE APT 1421
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-0002
Mailing Address - Country:US
Mailing Address - Phone:616-460-1020
Mailing Address - Fax:
Practice Address - Street 1:1124 28TH ST SW
Practice Address - Street 2:
Practice Address - City:WYOMING
Practice Address - State:MI
Practice Address - Zip Code:49509-2855
Practice Address - Country:US
Practice Address - Phone:616-530-9900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-29
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901022605122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist