Provider Demographics
NPI:1568494946
Name:FILBERT, BRYSON MCCOOL JR (DMD)
Entity Type:Individual
Prefix:
First Name:BRYSON
Middle Name:MCCOOL
Last Name:FILBERT
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 CHURCH HILL RD
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06470-1625
Mailing Address - Country:US
Mailing Address - Phone:203-426-3310
Mailing Address - Fax:
Practice Address - Street 1:34 CHURCH HILL RD
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:CT
Practice Address - Zip Code:06470-1625
Practice Address - Country:US
Practice Address - Phone:203-426-3310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT47471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice