Individual
BRYAR JEANNINE BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
5183 HINKLEVILLE RD, PADUCAH, KY 42001-9667
(270) 415-9006
Mailing address
225 N 31ST ST, PADUCAH, KY 42001-4317
(715) 326-1424
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11375
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/27/2025
Last updated
06/03/2025
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