Provider Demographics
NPI:1922024611
Name:LEMONE, BRYSON (DDS)
Entity type:Individual
Prefix:
First Name:BRYSON
Middle Name:
Last Name:LEMONE
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 1:4344 STAFFORD CT
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-5559
Mailing Address - Country:US
Mailing Address - Phone:702-610-5708
Mailing Address - Fax:
Practice Address - Street 1:1344 S 800 E STE 220
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84097-5503
Practice Address - Country:US
Practice Address - Phone:385-283-0147
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT53733266-9921122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist