Provider Demographics
NPI:1639111644
Name:DELONEY, JOHN BRYAN (DMD, PC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:BRYAN
Last Name:DELONEY
Suffix:
Gender:M
Credentials:DMD, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 ANDREWS AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:OZARK
Mailing Address - State:AL
Mailing Address - Zip Code:36360-3718
Mailing Address - Country:US
Mailing Address - Phone:334-774-8855
Mailing Address - Fax:334-445-1159
Practice Address - Street 1:1550 ANDREWS AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:OZARK
Practice Address - State:AL
Practice Address - Zip Code:36360-3718
Practice Address - Country:US
Practice Address - Phone:334-774-8855
Practice Address - Fax:334-445-1159
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL47781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice