Provider Demographics
NPI:1316045412
Name:CRAMM, BRYAN ALAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:ALAN
Last Name:CRAMM
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 1:15 MAREBLU SUITE 210
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656
Mailing Address - Country:US
Mailing Address - Phone:949-831-4193
Mailing Address - Fax:949-831-4197
Practice Address - Street 1:24541 PACIFIC PARK DR STE 210
Practice Address - Street 2:
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656-3050
Practice Address - Country:US
Practice Address - Phone:949-831-4193
Practice Address - Fax:949-831-4197
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA322871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice