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General NPI Number Information
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NPI Number | 1467147801
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Entity Type | Individual
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Provider Name | MICHAEL RYAN CLEARY DMD
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Gender | Male
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Dates
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Enumeration Date | 04/11/2023
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Last Update Date | 11/26/2024
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Provider Practice Location Address
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Address Line | 106 SAINT ANNES CHURCH RD
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City | MIDDLETOWN
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State | DE
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Zip | 19709
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Country | US
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Telephone | 302-378-8600
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Fax |
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Provider Business Mailing Address
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Address Line | 106 SAINT ANNES CHURCH RD
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City | MIDDLETOWN
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State | DE
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Zip | 19709-1495
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Country | US
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Telephone |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | G1-0011594
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | G1-0011594
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License Number State | DE
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