Provider Demographics
NPI:1487313284
Name:MATTHEW BRYINGTON DMD MS FACP PA
Entity type:Organization
Organization Name:MATTHEW BRYINGTON DMD MS FACP PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:S
Authorized Official - Last Name:BRYINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MS
Authorized Official - Phone:813-788-0451
Mailing Address - Street 1:37153 STATE ROAD 54
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33542-6935
Mailing Address - Country:US
Mailing Address - Phone:813-788-0451
Mailing Address - Fax:813-788-4190
Practice Address - Street 1:37153 STATE ROAD 54
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33542-6935
Practice Address - Country:US
Practice Address - Phone:813-788-0451
Practice Address - Fax:813-788-4190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-09
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental