Individual
DR. PAUL W BRYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
2903 E MAIN, PUYALLUP, WA 98372-3169
(253) 845-9507
(253) 845-5751
Mailing address
2903 E MAIN, PUYALLUP, WA 98372-3169
(253) 845-9507
(253) 845-5751
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5783
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5059001
DSHS PROVIDER NUMBER
WA
01
—
717917
UNITED CONCORDIA & TRICAR
WA
01
—
7192
WASHINGTON DENTAL SERVICE
WA
01
—
93062
L&I PROVIDER NUMBER
WA
Enumeration date
06/08/2006
Last updated
03/07/2023
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