Provider Demographics
NPI:1982605424
Name:NOYES, BRYAN W (DDS)
Entity Type:Individual
Prefix:
First Name:BRYAN
Middle Name:W
Last Name:NOYES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2240 SW 2ND ST
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97128-5583
Mailing Address - Country:US
Mailing Address - Phone:503-472-4347
Mailing Address - Fax:503-472-1029
Practice Address - Street 1:2240 SW 2ND ST
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128-5583
Practice Address - Country:US
Practice Address - Phone:503-472-4347
Practice Address - Fax:503-472-1029
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2008-09-12
Deactivation Date:2006-03-22
Deactivation Code:
Reactivation Date:2006-04-19
Provider Licenses
StateLicense IDTaxonomies
ORD73291223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry