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NPI Code Detail

MEDICARE: KATHERINE BRAY BRYANT D.M.D.

MEDICARE: KATHERINE BRAY BRYANT D.M.D.
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 Dentistry4046SC
21223P0221XPediatric Dentistry710SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1982781001
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE BRAY BRYANT D.M.D.
Provider Business Mailing Address
First Line : 716 W HARRISON RD
Second Line :
City : CHARLESTON
State : SC
Zip : 29407-7121
Country : US
Telephone Number : 843-797-5400
Fax Number :
Provider Business Practice Location Address
First Line : 7465 NORTHSIDE DR
Second Line :
City : NORTH CHARLESTON
State : SC
Zip : 29420-4209
Country : US
Telephone Number : 843-797-5400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 11/09/2012

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