Organization
EMORY W. BRYAN, JR.,D.D.S., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EMORY WALLACE BRYAN JR. D.D.S. (PRESIDENT)
(260) 485-9142
Entity
Organization
Contact information
Practice address
6427 GEORGETOWN NORTH BLVD, FORT WAYNE, IN 46815-7007
(260) 485-9142
(260) 485-9783
Mailing address
6427 GEORGETOWN NORTH BLVD, FORT WAYNE, IN 46815-7007
(260) 485-9142
(260) 485-9783
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
54000568A
IN
Other
Enumeration date
01/12/2007
Last updated
08/22/2020
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