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NPI Code Detail

MEDICARE: DR. RYAN COLLINS DMD

MEDICARE: DR. RYAN COLLINS DMD
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
1122300000XDentistD8851OR

General Provider Information

NPI Number : 1730258138
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RYAN COLLINS DMD
Provider Business Mailing Address
First Line : 5906 SE TAYLOR ST
Second Line :
City : PORTLAND
State : OR
Zip : 97215-2746
Country : US
Telephone Number : 503-507-0530
Fax Number :
Provider Business Practice Location Address
First Line : 2300 LANCASTER DR NE
Second Line : NORTH LANCASTER DENTAL OFFICE
City : SALEM
State : OR
Zip : 97305-1223
Country : US
Telephone Number : 503-370-4843
Fax Number : 503-375-5737
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2006
Last Update Date : 03/16/2010

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Directions to “ DR. RYAN COLLINS DMD” Practice Location

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