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NPI Code Detail

MEDICARE: DR. RYAN LEE RILEY D.D.S.

MEDICARE: DR. RYAN LEE RILEY 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
11223G0001XGeneral Practice Dentistry08473IA

General Provider Information

NPI Number : 1568662906
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RYAN LEE RILEY D.D.S.
Provider Business Mailing Address
First Line : 214 WATSON POWELL JR WAY
Second Line : UNIT 515
City : DES MOINES
State : IA
Zip : 50309-1713
Country : US
Telephone Number : 515-707-5345
Fax Number :
Provider Business Practice Location Address
First Line : 1111 9TH ST
Second Line : STE 190
City : DES MOINES
State : IA
Zip : 50314-2527
Country : US
Telephone Number : 515-244-9136
Fax Number : 515-244-9153
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2007
Last Update Date : 03/28/2014

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