Provider Demographics
NPI:1861548133
Name:BRYER, DAVID KIRK (DDS)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:KIRK
Last Name:BRYER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2675 CENTRAL AVE
Mailing Address - Street 2:LAMPLIGHTER SQUARE
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-6686
Mailing Address - Country:US
Mailing Address - Phone:406-652-7774
Mailing Address - Fax:406-652-1042
Practice Address - Street 1:2675 CENTRAL AVE
Practice Address - Street 2:LAMPLIGHTER SQUARE
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-6686
Practice Address - Country:US
Practice Address - Phone:406-652-7774
Practice Address - Fax:406-652-1042
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT18841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice