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General NPI Number Information
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NPI Number | 1518708445
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Entity Type | Individual
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Provider Name | RYAN MICHAEL HIMMEL DDS
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Gender | Male
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Dates
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Enumeration Date | 06/04/2024
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Last Update Date | 11/03/2025
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Provider Practice Location Address
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Address Line | 338 W ALLEGAN ST
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City | OTSEGO
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State | MI
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Zip | 49078-1012
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Country | US
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Telephone | 269-694-2074
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Fax |
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Provider Business Mailing Address
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Address Line | 1841 MISTY RDG SW
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City | BYRON CENTER
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State | MI
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Zip | 49315-8575
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Country | US
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Telephone | 269-364-5137
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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 | 2901602138
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License Number State | MI
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