Individual
MRS. SHELBY LAUREN BRYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDA
Contact information
Practice address
529 MARSHALL IVY RD, HUNTINGTON, TX 75949
(936) 240-9632
Mailing address
529 MARSHALL IVY RD, HUNTINGTON, TX 75949
(936) 240-9632
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
85316
TX
Other
Enumeration date
02/28/2019
Last updated
02/28/2019
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