Provider Demographics
NPI:1912318882
Name:BRYANT, KAYLA MCCARVER (DMD)
Entity Type:Individual
Prefix:MRS
First Name:KAYLA
Middle Name:MCCARVER
Last Name:BRYANT
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:25 EASTGATE DR.
Mailing Address - Street 2:SUITE B
Mailing Address - City:BRANDON
Mailing Address - State:MS
Mailing Address - Zip Code:39042
Mailing Address - Country:US
Mailing Address - Phone:601-824-0093
Mailing Address - Fax:601-825-0240
Practice Address - Street 1:25 EASTGATE DR.
Practice Address - Street 2:SUITE B
Practice Address - City:BRANDON
Practice Address - State:MS
Practice Address - Zip Code:39042
Practice Address - Country:US
Practice Address - Phone:601-824-0093
Practice Address - Fax:601-825-0240
Is Sole Proprietor?:No
Enumeration Date:2014-05-14
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MS3753-141223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program