Basic Information
| Provider Information | |||||||||
| NPI: | 1316295231 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BREIG | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | JAMES | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.M.D. ENDODONTIST | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3204 W SAN LUIS ST | ||||||||
| Address2: | |||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336298020 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5618273009 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 13146 US HIGHWAY 301 S | ||||||||
| Address2: | |||||||||
| City: | RIVERVIEW | ||||||||
| State: | FL | ||||||||
| PostalCode: | 335787410 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9157425935 | ||||||||
| FaxNumber: | 9157425174 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/27/2012 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223G0001X | DS039292 | PA | N | Dental Providers | Dentist | General Practice | 1223G0001X | 28414 | TX | N | Dental Providers | Dentist | General Practice | 1223E0200X | DN20068 | FL | Y | Dental Providers | Dentist | Endodontics |
No ID Information.