Individual
JONATHAN RYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5415 W HARMON AVE UNIT 2086, LAS VEGAS, NV 89103-7022
(702) 581-6482
Mailing address
5415 W HARMON AVE UNIT 2086, LAS VEGAS, NV 89103-7022
(702) 581-6482
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2104851114
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000197164
—
NV
Enumeration date
03/11/2015
Last updated
03/11/2015
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