Provider Demographics
NPI:1568103935
Name:MCLAIN, BRIANA SHEA (BS, RDH, LAP)
Entity Type:Individual
Prefix:
First Name:BRIANA
Middle Name:SHEA
Last Name:MCLAIN
Suffix:
Gender:F
Credentials:BS, RDH, LAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2502
Mailing Address - Street 2:
Mailing Address - City:HAVRE
Mailing Address - State:MT
Mailing Address - Zip Code:59501-2502
Mailing Address - Country:US
Mailing Address - Phone:406-945-0853
Mailing Address - Fax:
Practice Address - Street 1:6850 UPPER BOX ELDER RD
Practice Address - Street 2:
Practice Address - City:BOX ELDER
Practice Address - State:MT
Practice Address - Zip Code:59521-9073
Practice Address - Country:US
Practice Address - Phone:406-395-4486
Practice Address - Fax:406-395-5159
Is Sole Proprietor?:No
Enumeration Date:2022-04-07
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTDEN-RDH-LIC-11614124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist