Provider Demographics
NPI:1164517561
Name:BRYANT, ALAN D (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:D
Last Name:BRYANT
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 1:16326 426TH WAY SE
Mailing Address - Street 2:
Mailing Address - City:NORTH BEND
Mailing Address - State:WA
Mailing Address - Zip Code:98045-9045
Mailing Address - Country:US
Mailing Address - Phone:425-831-7266
Mailing Address - Fax:
Practice Address - Street 1:12600 SE 38TH ST STE 204
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98006-5236
Practice Address - Country:US
Practice Address - Phone:425-644-1612
Practice Address - Fax:425-644-4892
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA49061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice