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General NPI Number Information
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NPI Number | 1922345461
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Entity Type | Organization
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Legal Business Name | RON BRYANT, DDS, LLC
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Dates
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Enumeration Date | 01/03/2013
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Last Update Date | 01/03/2013
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Provider Practice Location Address
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Address Line | 504 WEST AVE
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City | NORTH AUGUSTA
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State | SC
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Zip | 29841-3709
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Country | US
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Telephone | 803-279-1880
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Fax | 803-279-1884
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Provider Business Mailing Address
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Address Line | 504 WEST AVE
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City | NORTH AUGUSTA
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State | SC
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Zip | 29841-3709
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Country | US
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Telephone | 803-279-1880
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Fax | 803-279-1884
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | RON BRYANT
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Credential | DDS
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Telephone | 803-279-1880
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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 | 3034
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License Number State | SC
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