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Organization

RYAN O'MALLEY LLC

Active
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Organization

RYAN O'MALLEY LLC

Active
Other names
Southern Oak Dental Simpsonville, O'Malley Dental
Organization subpart
No

Provider details

NPI number
Authorized official
CASEY CASTLE (DIRECTOR OF PAYOR CONTRACTS)
(912) 732-1504
Entity
Organization

Contact information

Practice address
419 SE MAIN ST, SUITE 100, SIMPSONVILLE, SC 29681-2673
(864) 962-4140
(864) 962-4142
Mailing address
419 SE MAIN ST STE 100, SIMPSONVILLE, SC 29681-2674
(864) 962-4140
(864) 962-4142

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
332BC3200X
Customized Equipment (DME)
6921
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1710290663
INDIVIDUAL NPI
SC
01
—
1831503580
INDIVIDUAL NPI
—
Enumeration date
02/18/2014
Last updated
06/11/2026
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