MEDICARE: DR. BRYAN NEAL PORTER D.D.S.

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	7712105-9923	UT

General Provider Information

NPI Number	:	1376773481
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRYAN NEAL PORTER D.D.S.

Provider Business Mailing Address
First Line	:	1320 N 600 E
Second Line	:	STE 4
City	:	LOGAN
State	:	UT
Zip	:	84341-2474
Country	:	US
Telephone Number	:	435-753-1690
Fax Number	:	435-752-2606

Provider Business Practice Location Address
First Line	:	3125 N MAIN ST
Second Line	:	SUITE #104
City	:	NORTH LOGAN
State	:	UT
Zip	:	84341-1547
Country	:	US
Telephone Number	:	435-787-4444
Fax Number	:	435-787-0044

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

Provider Enumeration Date	:	07/23/2009
Last Update Date	:	03/03/2016

Similar Medicare Providers

1942474440 — DR. SCOTT L MATSON DMD, BS
Practice Location Address:

3125 N MAIN ST , #3
NORTH LOGAN, UT
84341-1547

Practice Phone: 435-239-7212
Practice Fax: 435-535-2464

1922440031 — HYDE PARK DENTAL
Practice Location Address:

3125 N MAIN ST , SUITE 104
NORTH LOGAN, UT
84341-1547

Practice Phone: 435-787-4444
Practice Fax: 435-787-0044

1467524355 — SANDRA VAUSE, M.D., P.C.
Practice Location Address:

545 BECKETT RD STE 210 , PURELAND COMMONS
LOGAN TOWNSHIP, NJ
08085-1547

Practice Phone: 856-241-3311
Practice Fax: 856-241-3969

1174696462 — JAN P LONG MSN ANP-C
Practice Location Address:

545 BECKETT RD , SUITE 106
LOGAN TOWNSHIP, NJ
08085-1547

Practice Phone: 856-467-2556
Practice Fax: 856-467-3816

1336277169 — CARDIOVASCULAR GROUP-NJ LLC
Practice Location Address:

545 BECKETT RD , SUITE 101B
LOGAN TOWNSHIP, NJ
08085-1547

Practice Phone: 610-521-0150
Practice Fax: 610-521-6493

1578722856 — DR. NICOLE JASMYN BRIGHT D.O
Practice Location Address:

545 BECKETT RD , SUITE 101
LOGAN TOWNSHIP, NJ
08085-1547

Practice Phone: 856-241-3311
Practice Fax: 856-241-3969

Directions to “ DR. BRYAN NEAL PORTER D.D.S.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.