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Individual

DR. BRAD YOUNG BRYAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
4463 N STATE ST, JACKSON, MS 39206-5306
(601) 714-2908
Mailing address
4463 N STATE ST, JACKSON, MS 39206-5306
(601) 946-5908

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3347-05
MS

Other

Enumeration date
08/17/2006
Last updated
03/31/2015
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