Individual
DR. BRYAN D PETRYSZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
149 S MAIN ST, PORTVILLE, NY 14770-9703
(716) 933-6787
(716) 933-6933
Mailing address
149 S MAIN ST, PORTVILLE, NY 14770-9703
(716) 933-6787
(716) 933-6933
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
NY0502181
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02386001
—
NY
Enumeration date
10/13/2005
Last updated
07/08/2007
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