Provider Demographics
NPI:1033256755
Name:CHAPMAN, BRYAN M (DMD)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:M
Last Name:CHAPMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1355 S HIGLEY RD STE 119
Mailing Address - Street 2:
Mailing Address - City:HIGLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85236-4706
Mailing Address - Country:US
Mailing Address - Phone:480-279-3700
Mailing Address - Fax:480-279-3703
Practice Address - Street 1:1355 S HIGLEY RD STE 119
Practice Address - Street 2:
Practice Address - City:HIGLEY
Practice Address - State:AZ
Practice Address - Zip Code:85236-4706
Practice Address - Country:US
Practice Address - Phone:480-279-3700
Practice Address - Fax:480-279-3703
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD61891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice