Provider Demographics
NPI:1447256607
Name:DOSS, BRIAN E (DMD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:E
Last Name:DOSS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:978 US HIGHWAY 68 E
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:KY
Mailing Address - Zip Code:42025-7016
Mailing Address - Country:US
Mailing Address - Phone:270-527-1448
Mailing Address - Fax:270-527-5647
Practice Address - Street 1:978 US HIGHWAY 68 E
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:KY
Practice Address - Zip Code:42025-7016
Practice Address - Country:US
Practice Address - Phone:270-527-1448
Practice Address - Fax:270-527-5647
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY6787122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY67870OtherDELTA DENTAL
KY805038OtherUNITED CONCORDIA