Individual
JAMES RYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1409 N MICHIGAN ST, PLYMOUTH, IN 46563-1119
(574) 936-8787
Mailing address
1409 N MICHIGAN ST, PLYMOUTH, IN 46563-1119
(574) 936-8787
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12010965A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12010965A
STATE LICENSE
IN
Enumeration date
11/21/2006
Last updated
09/09/2024
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