Provider Demographics
NPI:1184868895
Name:MORGAN, BRYAN J (DDS)
Entity type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:J
Last Name:MORGAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:710 147TH CT NE
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34212-5588
Mailing Address - Country:US
Mailing Address - Phone:772-360-7731
Mailing Address - Fax:941-748-2464
Practice Address - Street 1:710 147TH CT NE
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34212-5588
Practice Address - Country:US
Practice Address - Phone:772-360-7731
Practice Address - Fax:941-748-2464
Is Sole Proprietor?:No
Enumeration Date:2009-04-24
Last Update Date:2014-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN192431223P0221X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry