MEDICARE: DR. DOUGLAS ADAMS BRYANS 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	9519	MA

General Provider Information

NPI Number	:	1477622678
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DOUGLAS ADAMS BRYANS DDS

Provider Business Mailing Address
First Line	:	30 HIGGINS CROWELL ROAD
Second Line	:	SUITE # 3
City	:	WEST YARMOUTH
State	:	MA
Zip	:	02673-3444
Country	:	US
Telephone Number	:	508-775-8655
Fax Number	:	508-775-4960

Provider Business Practice Location Address
First Line	:	30 HIGGINS CROWELL ROAD
Second Line	:	SUITE # 3
City	:	WEST YARMOUTH
State	:	MA
Zip	:	02673-3444
Country	:	US
Telephone Number	:	508-775-8655
Fax Number	:	508-775-4960

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

Provider Enumeration Date	:	11/06/2006
Last Update Date	:	07/08/2007

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