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NPI Code Detail

MEDICARE: DR. MICHAEL R BRYANT DDS

MEDICARE:  DR. MICHAEL R BRYANT  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
11223G0001XGeneral Practice Dentistry40545CA

General Provider Information

NPI Number : 1699886002
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL R BRYANT DDS
Provider Business Mailing Address
First Line : 28125 BRADLEY RD STE 210
Second Line :
City : SUN CITY
State : CA
Zip : 92586-2248
Country : US
Telephone Number : 951-679-0520
Fax Number : 951-679-8472
Provider Business Practice Location Address
First Line : 28125 BRADLEY RD STE 210
Second Line :
City : SUN CITY
State : CA
Zip : 92586-2248
Country : US
Telephone Number : 951-679-0520
Fax Number : 951-679-8472
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 06/13/2014

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Directions to “ DR. MICHAEL R BRYANT DDS” Practice Location

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