Provider Demographics
NPI:1144870858
Name:BRILOWSKI, KARIN REBECCA (DDS)
Entity type:Individual
Prefix:DR
First Name:KARIN
Middle Name:REBECCA
Last Name:BRILOWSKI
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 1:17000 W CAPITOL DR STE 12
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-2158
Mailing Address - Country:US
Mailing Address - Phone:262-373-0775
Mailing Address - Fax:
Practice Address - Street 1:17000 W CAPITOL DR STE 12
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-2158
Practice Address - Country:US
Practice Address - Phone:262-373-0775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-14
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1002535-151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice