Individual
DR. THEODORE PAUL BRYSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
30 E. HARPER ST., DRIGGS, ID 83422-5179
(208) 354-7878
Mailing address
PO BOX 1196, DRIGGS, ID 83422-1196
(208) 354-7878
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D3783
ID
Other
Enumeration date
08/23/2006
Last updated
07/08/2007
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