Provider Demographics
NPI:1801940515
Name:CHRYSLER, MARY B (DDS)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:B
Last Name:CHRYSLER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:L
Other - Last Name:BENNETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3561 W. M-76
Mailing Address - Street 2:P. O. BOX 515
Mailing Address - City:WEST BRANCH
Mailing Address - State:MI
Mailing Address - Zip Code:48661-0515
Mailing Address - Country:US
Mailing Address - Phone:989-345-7750
Mailing Address - Fax:
Practice Address - Street 1:3561 W. M-76
Practice Address - Street 2:
Practice Address - City:WEST BRANCH
Practice Address - State:MI
Practice Address - Zip Code:48661
Practice Address - Country:US
Practice Address - Phone:989-345-7750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010163121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice