Provider Demographics
NPI:1750557864
Name:MOHR, BRIAN ANTHONY (DDS)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:ANTHONY
Last Name:MOHR
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 1:7623 LOVETTA RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-7237
Mailing Address - Country:US
Mailing Address - Phone:281-376-9670
Mailing Address - Fax:
Practice Address - Street 1:7623 LOVETTA RD
Practice Address - Street 2:SUITE 101
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-7237
Practice Address - Country:US
Practice Address - Phone:281-376-9670
Practice Address - Fax:281-376-7291
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-08
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX144241223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics