Provider Demographics
NPI:1396824389
Name:BRANT, DALE JOSEPH (DDS)
Entity Type:Individual
Prefix:DR
First Name:DALE
Middle Name:JOSEPH
Last Name:BRANT
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 1:6560 FANNIN
Mailing Address - Street 2:SUITE 1424
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2713
Mailing Address - Country:US
Mailing Address - Phone:713-795-5905
Mailing Address - Fax:713-795-0806
Practice Address - Street 1:6560 FANNIN
Practice Address - Street 2:SUITE 1424
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2713
Practice Address - Country:US
Practice Address - Phone:713-795-5905
Practice Address - Fax:713-795-0806
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15696122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist