Provider Demographics
NPI:1104448190
Name:BRYANT, JESSICA GRACE (DMD)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:GRACE
Last Name:BRYANT
Suffix:
Gender:
Credentials:DMD
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:GRACE
Other - Last Name:GASSER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:354 BRIERLY RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT OLIVET
Mailing Address - State:KY
Mailing Address - Zip Code:41064-9441
Mailing Address - Country:US
Mailing Address - Phone:606-842-0507
Mailing Address - Fax:
Practice Address - Street 1:507 MARKETPLACE DR
Practice Address - Street 2:
Practice Address - City:MAYSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41056-7511
Practice Address - Country:US
Practice Address - Phone:606-564-4371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-12
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI2864122300000X
KY10982122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist