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General NPI Number Information
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NPI Number | 1578201778
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Entity Type | Organization
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Legal Business Name | BRYSON DENTAL P.L.L.C
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Dates
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Enumeration Date | 05/26/2022
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Last Update Date | 05/26/2022
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Provider Practice Location Address
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Address Line | 7785 E. M-36
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City | HAMBURG
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State | MI
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Zip | 48139
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Country | US
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Telephone | 810-231-9630
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Fax |
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Provider Business Mailing Address
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Address Line | 7785 M-36 BOX 569
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City | HAMBURG
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State | MI
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Zip | 48139-0569
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Country | US
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Telephone | 586-864-4675
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DOREEN ZAFFER
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Credential |
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Telephone | 810-231-9630
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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