Provider Demographics
NPI:1275584229
Name:BRYANT, ROY ROGER JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROY
Middle Name:ROGER
Last Name:BRYANT
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3115 BRUSHY CREEK RD
Mailing Address - Street 2:SUITE G
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29650-0903
Mailing Address - Country:US
Mailing Address - Phone:864-968-0900
Mailing Address - Fax:864-968-0100
Practice Address - Street 1:3115 BRUSHY CREEK RD
Practice Address - Street 2:SUITE G
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29650-0903
Practice Address - Country:US
Practice Address - Phone:864-968-0900
Practice Address - Fax:864-968-0100
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC38951223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery