Provider Demographics
NPI:1124615232
Name:BRYANT S. GREENE, DMD, PLLC
Entity type:Organization
Organization Name:BRYANT S. GREENE, DMD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRYANT
Authorized Official - Middle Name:S
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:828-467-9362
Mailing Address - Street 1:331 OLD MARSHALL HWY
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28804-9718
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:131 E MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28714-2968
Practice Address - Country:US
Practice Address - Phone:828-682-2979
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-22
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental