Provider Demographics
NPI:1346474822
Name:KING, BRYAN C (DMD, DDS)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:C
Last Name:KING
Suffix:
Gender:M
Credentials:DMD, DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:951 PENN AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15222-3802
Mailing Address - Country:US
Mailing Address - Phone:412-246-0600
Mailing Address - Fax:
Practice Address - Street 1:951 PENN AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15222-3802
Practice Address - Country:US
Practice Address - Phone:412-246-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-12
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0355561223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics