Provider Demographics
NPI:1588674808
Name:BRYANT AND JUNGE PS
Entity Type:Organization
Organization Name:BRYANT AND JUNGE PS
Other - Org Name:RONALD A BRYANT DDS MSD PS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DENTIST PROSTHODENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:A
Authorized Official - Last Name:BRYANT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MSD
Authorized Official - Phone:206-682-3383
Mailing Address - Street 1:509 OLIVE WAY
Mailing Address - Street 2:SUITE 1438
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101
Mailing Address - Country:US
Mailing Address - Phone:206-682-3383
Mailing Address - Fax:206-467-8160
Practice Address - Street 1:509 OLIVE WAY
Practice Address - Street 2:SUITE 1438
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101
Practice Address - Country:US
Practice Address - Phone:206-682-3383
Practice Address - Fax:206-467-8160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA48611223P0700X
WA95411223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA600305001OtherUBI
BJOther7048071
AB7262568OtherDEA