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General NPI Number Information
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NPI Number | 1366548588
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Entity Type | Individual
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Provider Name | JARON RYAH WEDDING D.D.S., M.S.D.
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Gender | Male
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Dates
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Enumeration Date | 09/15/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 522 N NEW BALLAS RD SUITE 382
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City | CREVE COEUR
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State | MO
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Zip | 63141-6857
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Country | US
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Telephone | 314-994-3737
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Fax |
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Provider Business Mailing Address
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Address Line | 12 WINNETKA LN
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City | SAINT LOUIS
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State | MO
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Zip | 63122-3252
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Country | US
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Telephone | 314-909-9199
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Fax |
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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 | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 2005019635
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License Number State | MO
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