Individual
JELANA RENEE BRYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
38 JEFFERSON PKWY, NEWNAN, GA 30263-5812
(470) 241-0143
Mailing address
PO BOX 71926, NEWNAN, GA 30271-1926
(470) 241-0143
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN014831
GA
Other
Enumeration date
07/11/2014
Last updated
10/20/2015
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