Provider Demographics
NPI:1821153628
Name:BRYANT, HEATHER DANIELLE (DDS)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:DANIELLE
Last Name:BRYANT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:HEATHER
Other - Middle Name:DANIELLE
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:11218 AIRLINE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77037-1116
Mailing Address - Country:US
Mailing Address - Phone:281-999-6500
Mailing Address - Fax:281-999-6504
Practice Address - Street 1:11218 AIRLINE DR.
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77037
Practice Address - Country:US
Practice Address - Phone:281-999-6500
Practice Address - Fax:281-999-6504
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX225181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice