Individual
MR. SHANE R BRYANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1334 WASHINGTON AVE, PORTLAND, ME 04103-3670
(207) 797-5834
(207) 797-8305
Mailing address
1334 WASHINGTON AVE, PORTLAND, ME 04103-3670
(207) 797-5834
(207) 797-8305
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3005
ME
Other
Enumeration date
03/23/2007
Last updated
07/08/2007
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