Provider Demographics
NPI:1891074472
Name:HSU, BRYAN HUMBERT (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:HUMBERT
Last Name:HSU
Suffix:
Gender:M
Credentials:DDS, MS
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Mailing Address - Street 1:3090 N GOLIAD ST STE 106
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087-7049
Mailing Address - Country:US
Mailing Address - Phone:972-722-2943
Mailing Address - Fax:972-722-2978
Practice Address - Street 1:3090 N GOLIAD ST STE 106
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087-7049
Practice Address - Country:US
Practice Address - Phone:972-722-2943
Practice Address - Fax:972-722-2978
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-12
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX286191223X0400X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics