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Individual
BRYAN GLEN TRUMP
Active
Individual
BRYAN GLEN TRUMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
9021109-9921
UT
Other
Enumeration date
05/11/2012
Last updated
12/20/2021
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