Organization
ANGELO ORAL & MAXILLOFACIAL SURGERY, P. A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GRADY W. BRYAN DDS, MD (PRESIDENT)
(325) 944-3565
Entity
Organization
Contact information
Practice address
3012 GREEN MEADOW DR, SAN ANGELO, TX 76904-6974
(325) 944-3565
Mailing address
3012 GREEN MEADOW DR, SAN ANGELO, TX 76904-6974
(325) 944-3565
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
14472
TX
Other
Enumeration date
03/01/2007
Last updated
08/22/2020
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