Provider Demographics
NPI:1043311889
Name:CARLIN, BRIAN T (DDS)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:T
Last Name:CARLIN
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 1:5046 WESTFORD CT
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:MI
Mailing Address - Zip Code:48433-1385
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2811 E COURT ST
Practice Address - Street 2:SUITE I
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48506-4054
Practice Address - Country:US
Practice Address - Phone:810-232-2920
Practice Address - Fax:810-232-1054
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010193411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4803176Medicaid