Provider Demographics
NPI:1265961825
Name:BRAYTON, BRIANA TAYLOR (DDS)
Entity type:Individual
Prefix:DR
First Name:BRIANA
Middle Name:TAYLOR
Last Name:BRAYTON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2790 120TH ST
Mailing Address - Street 2:
Mailing Address - City:MESERVEY
Mailing Address - State:IA
Mailing Address - Zip Code:50457-8711
Mailing Address - Country:US
Mailing Address - Phone:641-425-8471
Mailing Address - Fax:
Practice Address - Street 1:23 N FEDERAL AVE
Practice Address - Street 2:
Practice Address - City:MASON CITY
Practice Address - State:IA
Practice Address - Zip Code:50401-3250
Practice Address - Country:US
Practice Address - Phone:641-423-4225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-07
Last Update Date:2017-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IADDS-09419122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist