Provider Demographics
NPI:1447302674
Name:SEI, BRYAN JOSEPH (DDS)
Entity type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:JOSEPH
Last Name:SEI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 LOUISIANA BLVD NE STE F
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-1448
Mailing Address - Country:US
Mailing Address - Phone:505-881-8441
Mailing Address - Fax:
Practice Address - Street 1:3901 LOUISIANA BLVD NE STE F
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-1448
Practice Address - Country:US
Practice Address - Phone:505-881-8441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD 1769122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist