Provider Demographics
NPI:1417122185
Name:BRYAN DOWNING, D.D.S.
Entity Type:Organization
Organization Name:BRYAN DOWNING, D.D.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DOWNING
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:918-787-7977
Mailing Address - Street 1:6806 HIGHWAY 59 N
Mailing Address - Street 2:
Mailing Address - City:GROVE
Mailing Address - State:OK
Mailing Address - Zip Code:74344-4486
Mailing Address - Country:US
Mailing Address - Phone:918-787-7977
Mailing Address - Fax:
Practice Address - Street 1:6806 HIGHWAY 59 N
Practice Address - Street 2:
Practice Address - City:GROVE
Practice Address - State:OK
Practice Address - Zip Code:74344-4486
Practice Address - Country:US
Practice Address - Phone:918-787-7977
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-24
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK48551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1043284888OtherNPPES