Provider Demographics
NPI:1548001761
Name:BROZEK, ABBY SHAYE (DDS)
Entity type:Individual
Prefix:
First Name:ABBY
Middle Name:SHAYE
Last Name:BROZEK
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:ABBY
Other - Middle Name:SHAYE
Other - Last Name:KAUTZMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:541 PRAIRIE TRAIL RD UNIT 2
Mailing Address - Street 2:
Mailing Address - City:SHELDON
Mailing Address - State:IA
Mailing Address - Zip Code:51201-8571
Mailing Address - Country:US
Mailing Address - Phone:701-412-6093
Mailing Address - Fax:
Practice Address - Street 1:1002 3RD AVE
Practice Address - Street 2:
Practice Address - City:SHELDON
Practice Address - State:IA
Practice Address - Zip Code:51201-1551
Practice Address - Country:US
Practice Address - Phone:712-324-3646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IADDS-102051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice