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Individual

DR. RYAN T. MANGRUM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
7990 SHERIDAN BLVD, WESTMINSTER, CO 80003-6213
(303) 650-4101
Mailing address
7990 SHERIDAN BLVD, WESTMINSTER, CO 80003-6213
(303) 650-4101

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10066
CO

Other

Enumeration date
01/22/2010
Last updated
01/22/2010
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