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General NPI Number Information
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NPI Number | 1609513365
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Entity Type | Individual
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Provider Name | RYAN GUSBAR D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 05/15/2022
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Last Update Date | 05/15/2022
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Provider Practice Location Address
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Address Line | 6371 BRIDGETOWN RD
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City | CINCINNATI
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State | OH
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Zip | 45248-2943
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Country | US
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Telephone | 513-598-2157
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Fax |
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Provider Business Mailing Address
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Address Line | 280 AUDEN AVE UNIT 2B
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City | COLUMBUS
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State | OH
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Zip | 43215-1937
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Country | US
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Telephone | 330-316-9023
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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 | 30.026825
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License Number State | OH
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