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General NPI Number Information
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NPI Number | 1811158124
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Entity Type | Individual
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Provider Name | RYAN ALLEN CREGGER DDS, MS
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Gender | Male
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Dates
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Enumeration Date | 06/19/2008
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Last Update Date | 06/19/2008
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Provider Practice Location Address
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Address Line | 95 SEABOARD LN
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City | BRENTWOOD
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State | TN
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Zip | 37027-2929
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Country | US
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Telephone | 901-830-5075
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Fax |
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Provider Business Mailing Address
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Address Line | 95 SEABOARD LN
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City | BRENTWOOD
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State | TN
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Zip | 37027-2929
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 8825
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 22828
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License Number State | TX
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