MEDICARE: DR. RYAN P NEBEL D.M.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
1	122300000X	Dentist	DS037229	PA

General Provider Information

NPI Number	:	1093918567
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RYAN P NEBEL D.M.D.

Provider Business Mailing Address
First Line	:	3105 WILMINGTON RD
Second Line	:
City	:	NEW CASTLE
State	:	PA
Zip	:	16105-1131
Country	:	US
Telephone Number	:	724-654-2330
Fax Number	:	724-658-3719

Provider Business Practice Location Address
First Line	:	3105 WILMINGTON RD
Second Line	:
City	:	NEW CASTLE
State	:	PA
Zip	:	16105-1131
Country	:	US
Telephone Number	:	724-654-2330
Fax Number	:	724-658-3719

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/11/2007
Last Update Date	:	11/14/2022

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