Provider Demographics
NPI:1659710465
Name:BRYANT, DOUGLAS COLLIN (DMD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:COLLIN
Last Name:BRYANT
Suffix:
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 1:1515 N FANT ST
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-4707
Mailing Address - Country:US
Mailing Address - Phone:864-844-9393
Mailing Address - Fax:864-844-9395
Practice Address - Street 1:1515 N FANT ST
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-4707
Practice Address - Country:US
Practice Address - Phone:864-844-9393
Practice Address - Fax:864-844-9395
Is Sole Proprietor?:No
Enumeration Date:2013-06-14
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC874 PD1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry