Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 9103 | TN |
NPI | 1043221823 |
---|---|
Provider Name | Dr. Bryce F Mccreary |
First Address | Memphis, TN 38133-8191 |
Second Address | Memphis, TN 38133-8191 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2006 |
Last Update Date | 17/12/2014 |