Provider Demographics
NPI:1093912834
Name:GEARY, BRYAN THOMAS (DDS)
Entity type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:THOMAS
Last Name:GEARY
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:PO BOX 1485
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN
Mailing Address - State:VA
Mailing Address - Zip Code:23692-1485
Mailing Address - Country:US
Mailing Address - Phone:757-898-4661
Mailing Address - Fax:757-890-2227
Practice Address - Street 1:105 TERREBONNE RD
Practice Address - Street 2:
Practice Address - City:YORKTOWN
Practice Address - State:VA
Practice Address - Zip Code:23692-4817
Practice Address - Country:US
Practice Address - Phone:757-898-4661
Practice Address - Fax:757-890-2227
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014118651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice