MEDICARE: RYAN R ZLEIK DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	109013	CA

General Provider Information

NPI Number	:	1386326361
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RYAN R ZLEIK DDS

Provider Business Mailing Address
First Line	:	4434 FRENCH DR
Second Line	:
City	:	FOLSOM
State	:	CA
Zip	:	95630-6033
Country	:	US
Telephone Number	:	402-214-5818
Fax Number	:

Provider Business Practice Location Address
First Line	:	3967 MISSOURI FLAT RD STE 120
Second Line	:
City	:	PLACERVILLE
State	:	CA
Zip	:	95667-5250
Country	:	US
Telephone Number	:	530-642-2876
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2023
Last Update Date	:	08/01/2023

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