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Individual

DR. BRIAN LEE SECRIST

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
1900 E MAIN ST, DANVILLE, IL 61832-5100
(217) 554-5859
Mailing address
24206 MATEO RDG, SAN ANTONIO, TX 78261-4504
(303) 859-6016

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
105294
CO

Other

Enumeration date
07/11/2005
Last updated
10/24/2024
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