Provider Demographics
NPI:1790704021
Name:BRYAN, JOHN STERLING (DDS)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:STERLING
Last Name:BRYAN
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 1:505 HILLTOP CT
Mailing Address - Street 2:
Mailing Address - City:TAFT
Mailing Address - State:CA
Mailing Address - Zip Code:93268-4508
Mailing Address - Country:US
Mailing Address - Phone:661-763-4514
Mailing Address - Fax:
Practice Address - Street 1:510 6TH ST
Practice Address - Street 2:
Practice Address - City:TAFT
Practice Address - State:CA
Practice Address - Zip Code:93268-2320
Practice Address - Country:US
Practice Address - Phone:661-763-4161
Practice Address - Fax:661-763-4162
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA303561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice