Provider Demographics
NPI:1659479574
Name:DONNIE R. BRYANT, DDS, PLLC
Entity type:Organization
Organization Name:DONNIE R. BRYANT, DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DDS/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:DONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRYANT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:870-226-6556
Mailing Address - Street 1:105 W CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:AR
Mailing Address - Zip Code:71671-2809
Mailing Address - Country:US
Mailing Address - Phone:870-226-6556
Mailing Address - Fax:870-226-6150
Practice Address - Street 1:105 W CHURCH ST
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:AR
Practice Address - Zip Code:71671-2809
Practice Address - Country:US
Practice Address - Phone:870-226-6556
Practice Address - Fax:870-226-6150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR34801223G0001X
AR21811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty