Provider Demographics
NPI:1740686567
Name:BRITTAIN, DENNIS DALE (DC)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:DALE
Last Name:BRITTAIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:494 HIGHWAY 71 W
Mailing Address - Street 2:140-301
Mailing Address - City:BASTROP
Mailing Address - State:TX
Mailing Address - Zip Code:78602-3793
Mailing Address - Country:US
Mailing Address - Phone:512-921-8055
Mailing Address - Fax:512-412-6140
Practice Address - Street 1:106 INDUSTRY DR
Practice Address - Street 2:
Practice Address - City:BASTROP
Practice Address - State:TX
Practice Address - Zip Code:78602-4600
Practice Address - Country:US
Practice Address - Phone:512-921-8055
Practice Address - Fax:512-412-6140
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-05
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12643111N00000X
CA1940111N00000X
WACH60319280111N00000X
CA15146111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor