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NPI Code Detail

MEDICARE: RYAN MARC FRIEDRICH D.D.S

MEDICARE: RYAN MARC FRIEDRICH D.D.S
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
1122300000XDentist10482GA

General Provider Information

NPI Number : 1215114558
Entity Type Code : Individual
Provider Name (Legal Business Name) : RYAN MARC FRIEDRICH D.D.S
Provider Business Mailing Address
First Line : 2625 PIEDMONT RD NE
Second Line : SUITE G35
City : ATLANTA
State : GA
Zip : 30324-3086
Country : US
Telephone Number : 404-240-0222
Fax Number :
Provider Business Practice Location Address
First Line : 2625 PIEDMONT RD NE
Second Line : SUITE G35
City : ATLANTA
State : GA
Zip : 30324-3086
Country : US
Telephone Number : 404-240-0222
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2008
Last Update Date : 01/29/2008

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