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General NPI Number Information
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NPI Number | 1194536136
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Entity Type | Organization
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Legal Business Name | BRYAN T PERSINGER DDS PLLC III
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Dates
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Enumeration Date | 01/17/2025
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 10011 BIDDICK LN STE 140
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-8210
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Country | US
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Telephone | 704-778-6757
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Fax |
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Provider Business Mailing Address
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Address Line | 19628 WEAVERS CIR
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City | CORNELIUS
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State | NC
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Zip | 28031-7534
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Country | US
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Telephone | 704-778-6757
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | TRACIE PERSINGER
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Credential |
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Telephone | 704-778-6757
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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