Provider Demographics
NPI:1457471302
Name:PRATT, BRIAN CHRISTOPHER (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:CHRISTOPHER
Last Name:PRATT
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 1:15260 HIGHWAY 105 W
Mailing Address - Street 2:SUITE 222
Mailing Address - City:MONTGOMERY
Mailing Address - State:TX
Mailing Address - Zip Code:77356-5259
Mailing Address - Country:US
Mailing Address - Phone:832-381-6724
Mailing Address - Fax:
Practice Address - Street 1:9816 MEMORIAL BLVD
Practice Address - Street 2:101
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-4255
Practice Address - Country:US
Practice Address - Phone:281-446-6527
Practice Address - Fax:281-446-3619
Is Sole Proprietor?:No
Enumeration Date:2007-03-31
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX217381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice