Provider Demographics
NPI:1689083040
Name:CREMEAN, BRYCE (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRYCE
Middle Name:
Last Name:CREMEAN
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 1:6303 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-2467
Mailing Address - Country:US
Mailing Address - Phone:440-951-5511
Mailing Address - Fax:
Practice Address - Street 1:6303 CENTER ST
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-2467
Practice Address - Country:US
Practice Address - Phone:440-951-5511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-10
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV65531223G0001X
OH30.0249191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice