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General NPI Number Information
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NPI Number | 1043300411
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Entity Type | Individual
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Provider Name | RYAN C JOHNSTUN DDS
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Gender | Male
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 01/02/2025
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Provider Practice Location Address
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Address Line | 778 CIBOLO VALLEY DR STE 119
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City | CIBOLO
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State | TX
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Zip | 78108-4553
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Country | US
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Telephone | 210-436-8823
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Fax |
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Provider Business Mailing Address
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Address Line | 778 CIBOLO VALLEY DR STE 119
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City | CIBOLO
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State | TX
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Zip | 78108-4553
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Country | US
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Telephone | 360-436-1008
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Fax | 360-436-1147
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 39099
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License Number State | TX
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