Individual
DR. GARY L BRYANT
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
104 N PRAIRIE AVE, WAGONER, OK 74467-4320
(918) 485-4559
(918) 485-4550
Mailing address
PO BOX 448, WAGONER, OK 74477-0448
(918) 485-4559
(918) 485-4550
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4016
OK
Other
Enumeration date
06/23/2005
Last updated
07/08/2007
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