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General NPI Number Information
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NPI Number | 1386136760
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Entity Type | Individual
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Provider Name | RYAN MICHAEL NAHAN DDS
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Gender | Male
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Dates
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Enumeration Date | 06/01/2018
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Last Update Date | 02/03/2022
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Provider Practice Location Address
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Address Line | 1651 DALE ST N
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City | SAINT PAUL
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State | MN
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Zip | 55117-3414
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Country | US
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Telephone | 651-413-9150
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Fax |
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Provider Business Mailing Address
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Address Line | 1659 73RD ST W
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City | INVER GROVE HEIGHTS
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State | MN
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Zip | 55077
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Country | US
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Telephone | 320-250-9963
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | D13975
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License Number State | MN
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