Provider Demographics
NPI:1790875854
Name:BRYANT, MIRLINA E (DMD)
Entity Type:Individual
Prefix:DR
First Name:MIRLINA
Middle Name:E
Last Name:BRYANT
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:MIRLINA
Other - Middle Name:E
Other - Last Name:HILAIRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:10901 LITTLE PATUXENT PKWY, HSB 312
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-3197
Mailing Address - Country:US
Mailing Address - Phone:443-518-4985
Mailing Address - Fax:
Practice Address - Street 1:10901 LITTLE PATUXENT PARKWAY
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-2104
Practice Address - Country:US
Practice Address - Phone:443-518-1570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN10007661223G0001X
MA211491223G0001X
MD14144122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice