Individual
BRYANT ANTHONY IRAWAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2643 APPIAN WAY STE B, PINOLE, CA 94564-2253
(510) 758-0900
Mailing address
1685 7TH AVE, SAN FRANCISCO, CA 94122-3716
(626) 340-3404
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
103922
CA
Other
Enumeration date
07/02/2019
Last updated
07/02/2019
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