Healthcare Provider Details

I. General information

NPI: 1033598271
Provider Name (Legal Business Name): RYAN MICHAEL GERMAIN DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2015
Last Update Date: 08/22/2025
Certification Date: 08/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48 MDG OPC 41 BOX 15
APO AE
09461
US

IV. Provider business mailing address

48 MDG OPC 41 BOX 15
APO AE
09461
US

V. Phone/Fax

Practice location:
  • Phone: 163-852-8010
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number7242
License Number StateNE
# 3
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number7242
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: