Provider Demographics
NPI:1396848867
Name:SCHRAW, BRIANNA LEIGH (DMD)
Entity Type:Individual
Prefix:MRS
First Name:BRIANNA
Middle Name:LEIGH
Last Name:SCHRAW
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1096 ASSEMBLY DRIVE
Mailing Address - Street 2:SUITE 216
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29708
Mailing Address - Country:US
Mailing Address - Phone:803-548-4899
Mailing Address - Fax:803-548-6414
Practice Address - Street 1:1096 ASSEMBLY DRIVE
Practice Address - Street 2:SUITE 216
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29708
Practice Address - Country:US
Practice Address - Phone:803-548-4899
Practice Address - Fax:803-548-6414
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3909122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCZA9498Medicaid