Provider Demographics
NPI:1669435806
Name:HARVEY, BRYAN R (DDS,MS,PC)
Entity type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:R
Last Name:HARVEY
Suffix:
Gender:M
Credentials:DDS,MS,PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 WARNER MILNE RD
Mailing Address - Street 2:
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-4045
Mailing Address - Country:US
Mailing Address - Phone:503-655-6239
Mailing Address - Fax:503-655-0338
Practice Address - Street 1:331 WARNER MILNE RD
Practice Address - Street 2:
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-4045
Practice Address - Country:US
Practice Address - Phone:503-655-6239
Practice Address - Fax:503-655-0338
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD82831223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology