Provider Demographics
NPI:1134305915
Name:MCSWEENY, BRYAN J JR (DMD)
Entity Type:Individual
Prefix:
First Name:BRYAN
Middle Name:J
Last Name:MCSWEENY
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 982
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:MA
Mailing Address - Zip Code:02738-0018
Mailing Address - Country:US
Mailing Address - Phone:508-748-1380
Mailing Address - Fax:508-748-1380
Practice Address - Street 1:154 FRONT STREET
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:MA
Practice Address - Zip Code:02738
Practice Address - Country:US
Practice Address - Phone:508-748-1380
Practice Address - Fax:508-748-1380
Is Sole Proprietor?:No
Enumeration Date:2008-01-11
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMA118001223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics