Provider Demographics
NPI:1568587830
Name:BATTERSHELL, BRIAN D
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:D
Last Name:BATTERSHELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 N 8TH ST
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76541-4818
Mailing Address - Country:US
Mailing Address - Phone:254-634-4435
Mailing Address - Fax:
Practice Address - Street 1:809 N 8TH ST
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76541-4818
Practice Address - Country:US
Practice Address - Phone:254-634-4435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14720122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist