MEDICARE: AMY MICHELLE BATTEN BRYAN DDS

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	1223G0001X	General Practice Dentistry	7406	NC

General Provider Information

NPI Number	:	1073614731
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY MICHELLE BATTEN BRYAN DDS

Provider Business Mailing Address
First Line	:	2300 WAYNE MEMORIAL DR STE I
Second Line	:
City	:	GOLDSBORO
State	:	NC
Zip	:	27534-1747
Country	:	US
Telephone Number	:	919-734-0922
Fax Number	:

Provider Business Practice Location Address
First Line	:	2300 WAYNE MEMORIAL DR STE I
Second Line	:
City	:	GOLDSBORO
State	:	NC
Zip	:	27534-1747
Country	:	US
Telephone Number	:	919-734-0922
Fax Number	:

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

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	05/23/2023

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