Provider Demographics
NPI:1104836139
Name:BRYAN, JAMES DONALD (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DONALD
Last Name:BRYAN
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Gender:M
Credentials:DDS, MS
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Mailing Address - Street 1:27620 MARGUERITE PKWY
Mailing Address - Street 2:SUITE D
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92692-3607
Mailing Address - Country:US
Mailing Address - Phone:949-364-6633
Mailing Address - Fax:949-364-6696
Practice Address - Street 1:27620 MARGUERITE PKWY
Practice Address - Street 2:SUITE D
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92692-3607
Practice Address - Country:US
Practice Address - Phone:949-364-6633
Practice Address - Fax:949-364-6696
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CA445701223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics