Provider Demographics
NPI:1427010172
Name:BRATTON, BRYAN DEAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:DEAN
Last Name:BRATTON
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 1:116 E 14TH ST
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:OK
Mailing Address - Zip Code:74820-6518
Mailing Address - Country:US
Mailing Address - Phone:580-272-0222
Mailing Address - Fax:
Practice Address - Street 1:116 E 14TH ST
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:OK
Practice Address - Zip Code:74820-6518
Practice Address - Country:US
Practice Address - Phone:580-272-0222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-06
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5840122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist