Provider Demographics
NPI:1205904091
Name:BRYANT, JOSEPH RONALD (DDS)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:RONALD
Last Name:BRYANT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:JOSEPH
Other - Middle Name:RONALD
Other - Last Name:CRAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:3251 NW 64TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-2616
Mailing Address - Country:US
Mailing Address - Phone:509-720-3041
Mailing Address - Fax:
Practice Address - Street 1:3251 NW 64TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-2616
Practice Address - Country:US
Practice Address - Phone:509-720-3041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000067321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice