Individual
RYAN STEVEN PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4TH & INNER LOOP ROAD, BLDG 171, FORT IRWIN, CA 92310
(719) 526-5537
(706) 787-2082
Mailing address
4TH & INNER LOOP ROAD, BLDG 171, FORT IRWIN, CA 92310
(760) 383-5289
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
D-4656
ID
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
S2-167C
NV
Other
Enumeration date
08/04/2015
Last updated
07/03/2023
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