# DR CARLA BRYAN DDS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205176468
- **Authorized official:** DR. CARLA PETERSON BRYAN DDS (OWNER)
- **Authorized official phone:** (949) 487-6780

## Contact information

- **Practice address:** 657 CAMINO DE LOS MARES STE 138, SAN CLEMENTE, CA 92673-2810
- **Practice address phone:** (949) 487-6780
- **Practice address fax:** (949) 487-6781
- **Mailing address:** 657 CAMINO DE LOS MARES STE 138, SAN CLEMENTE, CA 92673-2810
- **Mailing address phone:** (949) 487-6780
- **Mailing address fax:** (949) 487-6781

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | DV25362 | CA | Yes |

## Other

- **Enumeration date:** 02/26/2013
- **Last updated:** 02/26/2013