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NPI Code Detail

MEDICARE: DR. JOSEPH RYAN KOLODY D.D.S., M.S.D.

MEDICARE:  DR. JOSEPH RYAN KOLODY  D.D.S., M.S.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223X0400XOrthodontics and Dentofacial Orthopedics Dentistry52878CA

General Provider Information

NPI Number : 1063536654
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSEPH RYAN KOLODY D.D.S., M.S.D.
Provider Business Mailing Address
First Line : 1600 COLORADO AVE
Second Line : 2
City : TURLOCK
State : CA
Zip : 95382-2713
Country : US
Telephone Number : 209-668-7001
Fax Number :
Provider Business Practice Location Address
First Line : 1600 COLORADO AVE
Second Line : SUITE 2
City : TURLOCK
State : CA
Zip : 95382-2713
Country : US
Telephone Number : 209-668-7001
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2007
Last Update Date : 07/08/2007

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Directions to “ DR. JOSEPH RYAN KOLODY D.D.S., M.S.D.” Practice Location

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