Provider Demographics
NPI:1811369945
Name:VREELAND, BYRON
Entity Type:Individual
Prefix:DR
First Name:BYRON
Middle Name:
Last Name:VREELAND
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:BYRON
Other - Middle Name:ROBERT
Other - Last Name:VREELAND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:10514 HEBRON LN
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90077-2722
Mailing Address - Country:US
Mailing Address - Phone:310-474-8755
Mailing Address - Fax:
Practice Address - Street 1:10514 HEBRON LN
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90077-2722
Practice Address - Country:US
Practice Address - Phone:310-474-8755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-28
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15608122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist