Provider Demographics
NPI:1093879355
Name:FRANCEY, BRYAN (DDS)
Entity Type:Individual
Prefix:
First Name:BRYAN
Middle Name:
Last Name:FRANCEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 PARK ST
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:NY
Mailing Address - Zip Code:13617-1365
Mailing Address - Country:US
Mailing Address - Phone:315-386-3886
Mailing Address - Fax:315-386-1844
Practice Address - Street 1:22 PARK ST
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:NY
Practice Address - Zip Code:13617-1365
Practice Address - Country:US
Practice Address - Phone:315-386-3886
Practice Address - Fax:315-386-1844
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0488381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00570383Medicaid