Healthcare Provider Details

I. General information

NPI: 1184805442
Provider Name (Legal Business Name): SHANNA LYNN BRITT DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2007
Last Update Date: 05/02/2023
Certification Date: 05/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 W REYNOSA AVE
DE LEON TX
76444-1630
US

IV. Provider business mailing address

1100 W. REYNOSA AVE.
DE LEON TX
76444-1630
US

V. Phone/Fax

Practice location:
  • Phone: 254-893-5895
  • Fax: 888-895-1214
Mailing address:
  • Phone: 254-893-5895
  • Fax: 888-895-1214

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number19735
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: