Individual
DR. TANYA M O'BRYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
6181 HIGHWAY 18, BRANDON, MS 39042-8296
(601) 825-0559
(601) 825-0374
Mailing address
6181 HIGHWAY 18, BRANDON, MS 39042-8296
(601) 825-0559
(601) 825-0374
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
318201
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00660415
—
MS
Enumeration date
03/05/2008
Last updated
10/10/2012
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