Provider Demographics
NPI:1295021673
Name:BRYSON, JEFFREY CLEO (DDS)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:CLEO
Last Name:BRYSON
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 1:8501 E ALAMEDA AVE UNIT 1835
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80230-6057
Mailing Address - Country:US
Mailing Address - Phone:402-517-5495
Mailing Address - Fax:
Practice Address - Street 1:18335 E 103RD AVE
Practice Address - Street 2:
Practice Address - City:COMMERCE CITY
Practice Address - State:CO
Practice Address - Zip Code:80022-3102
Practice Address - Country:US
Practice Address - Phone:303-853-9955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-23
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO104661223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry