Provider Demographics
NPI:1932232238
Name:SICHER, BRYAN G (DMD)
Entity Type:Individual
Prefix:
First Name:BRYAN
Middle Name:G
Last Name:SICHER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 WESTWIND RD
Mailing Address - Street 2:
Mailing Address - City:MONETA
Mailing Address - State:VA
Mailing Address - Zip Code:24121-3717
Mailing Address - Country:US
Mailing Address - Phone:540-721-3800
Mailing Address - Fax:540-721-0738
Practice Address - Street 1:15 WESTWIND RD
Practice Address - Street 2:
Practice Address - City:MONETA
Practice Address - State:VA
Practice Address - Zip Code:24121-3717
Practice Address - Country:US
Practice Address - Phone:540-721-3800
Practice Address - Fax:540-721-0738
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010070601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice