Dudzik, Bryant
Dudzik, Bryant is an sole proprietor health care provider with primary practice located at 465 Memorial Dr , Pocatello ID 83201-4008. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Dudzik, Bryant can be contacted via phone (208) 282-6000.Contact Information
Primary practice address
465 Memorial Dr
Pocatello ID 83201-4008
Phone: (208) 282-6000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | D4852 | Idaho |
Profile Details
| NPI number | 1811413669 |
|---|---|
| LBN Legal business name | Dudzik, Bryant |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 14th, 2017 |
| Last updated | Aug 14th, 2017 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1811413669 | NPPES |
| Idaho | MEDICAID | D4852 |
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