Provider Demographics
NPI:1326533068
Name:CHAMBERS, BRYCE ASHTON (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRYCE
Middle Name:ASHTON
Last Name:CHAMBERS
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 1:6284 WOODCREST DR
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123-7742
Mailing Address - Country:US
Mailing Address - Phone:317-750-3829
Mailing Address - Fax:
Practice Address - Street 1:6010 W 86TH ST STE 118
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46278-1407
Practice Address - Country:US
Practice Address - Phone:317-872-4746
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-26
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12012964A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice