MEDICARE: DR. RYAN MICHAEL OWASKI 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
1	1223P0221X	Pediatric Dentistry	DN 18578	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376772137
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RYAN MICHAEL OWASKI D.D.S.

Provider Business Mailing Address
First Line	:	272 FEATHER PT S
Second Line	:
City	:	JUPITER
State	:	FL
Zip	:	33458-8346
Country	:	US
Telephone Number	:	917-445-7835
Fax Number	:

Provider Business Practice Location Address
First Line	:	11382 PROSPERITY FARMS RD STE 129
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-3463
Country	:	US
Telephone Number	:	561-622-9601
Fax Number	:

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

Provider Enumeration Date	:	07/14/2009
Last Update Date	:	05/08/2018

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