Provider Demographics
NPI:1619102696
Name:SPURRIER, BRYAN RANDALL (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:RANDALL
Last Name:SPURRIER
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 1:2153 ASTORIA CIR APT 109
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170-4057
Mailing Address - Country:US
Mailing Address - Phone:703-774-6800
Mailing Address - Fax:
Practice Address - Street 1:808 PINEY FOREST RD
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24540-2812
Practice Address - Country:US
Practice Address - Phone:434-792-0141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-20
Last Update Date:2009-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC84941223X0400X
VA04014106131223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics