MEDICARE: DR. MICHAEL DARRH BRYANT D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DN16673	FL

General Provider Information

NPI Number	:	1891988531
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL DARRH BRYANT D.M.D.

Provider Business Mailing Address
First Line	:	1234 TIMBERLANE RD
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32312-1710
Country	:	US
Telephone Number	:	850-656-5600
Fax Number	:	850-665-5970

Provider Business Practice Location Address
First Line	:	1234 TIMBERLANE RD
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32312-1710
Country	:	US
Telephone Number	:	850-656-5600
Fax Number	:	850-665-5970

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/27/2007
Last Update Date	:	05/12/2015

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