Provider Demographics
NPI:1487641171
Name:BRYER, AMY LYNN (DDS)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:LYNN
Last Name:BRYER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:MRS
Other - First Name:AMY
Other - Middle Name:LYNN BRYER
Other - Last Name:ROJAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:3111 BYRON ST
Mailing Address - Street 2:# B
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92106-2644
Mailing Address - Country:US
Mailing Address - Phone:917-710-2316
Mailing Address - Fax:
Practice Address - Street 1:140 SYLVESTER RD
Practice Address - Street 2:DENTAL DEPT
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92106-3521
Practice Address - Country:US
Practice Address - Phone:619-556-9173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0515451122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist