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General NPI Number Information
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NPI Number | 1780716522
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Entity Type | Individual
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Provider Name | MICHAEL J RYAN D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 73 OAK RIDGE ROAD
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City | OAK RIDGE
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State | NJ
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Zip | 07438
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Country | US
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Telephone | 973-697-3900
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Fax | 973-697-5448
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Provider Business Mailing Address
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Address Line | 18 E SHORE TRL
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City | SPARTA
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State | NJ
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Zip | 07871-2201
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Country | US
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Telephone | 973-729-0591
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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 | 120389
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License Number State | NJ
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