Provider Demographics
NPI:1225145121
Name:GARRISON, BRIAN E (DDS)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:E
Last Name:GARRISON
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 1:910 KATHERINE AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:ASHLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44805-3692
Mailing Address - Country:US
Mailing Address - Phone:419-289-1813
Mailing Address - Fax:419-281-8279
Practice Address - Street 1:910 KATHERINE AVE
Practice Address - Street 2:SUITE A
Practice Address - City:ASHLAND
Practice Address - State:OH
Practice Address - Zip Code:44805-3692
Practice Address - Country:US
Practice Address - Phone:419-289-1813
Practice Address - Fax:419-281-8279
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH196741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice