Provider Demographics
NPI:1114968831
Name:HAIGHT, BRYAN DREW (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:DREW
Last Name:HAIGHT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:865 OILFIELD AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:SHELBY
Mailing Address - State:MT
Mailing Address - Zip Code:59474-2702
Mailing Address - Country:US
Mailing Address - Phone:406-434-7086
Mailing Address - Fax:
Practice Address - Street 1:865 OILFIELD AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:SHELBY
Practice Address - State:MT
Practice Address - Zip Code:59474-2702
Practice Address - Country:US
Practice Address - Phone:406-434-7086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT23411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice