Provider Demographics
NPI:1730703794
Name:BRYANT, RONALD MARTIN III (DMD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:MARTIN
Last Name:BRYANT
Suffix:III
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 LE MOYNE DR
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29907-1329
Mailing Address - Country:US
Mailing Address - Phone:334-322-4181
Mailing Address - Fax:
Practice Address - Street 1:674 BOULEVARD DE FRANCE
Practice Address - Street 2:
Practice Address - City:MCRD PARRIS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29905
Practice Address - Country:US
Practice Address - Phone:334-322-4181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-04
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALD.0006754-C1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist