Provider Demographics
NPI:1053535914
Name:ANDRESS, BRIAN HAROLD (DDS)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:HAROLD
Last Name:ANDRESS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40255 GRAND RIVER AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375
Mailing Address - Country:US
Mailing Address - Phone:248-442-0400
Mailing Address - Fax:248-471-7465
Practice Address - Street 1:40255 GRAND RIVER AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375
Practice Address - Country:US
Practice Address - Phone:248-442-0400
Practice Address - Fax:248-471-7465
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI14373122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist