Provider Demographics
NPI:1811124068
Name:BRATCHER, MICHELLE E (RDH, BS)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:E
Last Name:BRATCHER
Suffix:
Gender:F
Credentials:RDH, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 FM 548
Mailing Address - Street 2:STE 100
Mailing Address - City:FORNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75126-6284
Mailing Address - Country:US
Mailing Address - Phone:972-552-5128
Mailing Address - Fax:972-552-5041
Practice Address - Street 1:501 FM 548
Practice Address - Street 2:STE 100
Practice Address - City:FORNEY
Practice Address - State:TX
Practice Address - Zip Code:75126-6284
Practice Address - Country:US
Practice Address - Phone:972-552-5128
Practice Address - Fax:972-552-5041
Is Sole Proprietor?:No
Enumeration Date:2009-06-15
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12615124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist