Healthcare Provider Details

I. General information

NPI: 1710626445
Provider Name (Legal Business Name): DAVID RYKER DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2022
Last Update Date: 06/01/2022
Certification Date: 06/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 FOREST AVE
DAYTON OH
45405-4500
US

IV. Provider business mailing address

300 HIGH ST FL 3
HAMILTON OH
45011-6078
US

V. Phone/Fax

Practice location:
  • Phone: 937-535-5060
  • Fax:
Mailing address:
  • Phone: 513-454-1460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number30.026869
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: