Organization
ANDRIS FAMILY DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN WAYNE ANDRIS D.M.D. (DENTIST/OWNER)
(309) 263-8317
Entity
Organization
Contact information
Practice address
636 W JEFFERSON ST, MORTON, IL 61550-1581
(309) 263-8317
(309) 263-2175
Mailing address
636 W JEFFERSON ST, MORTON, IL 61550-1581
(309) 263-8317
(309) 263-2175
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
019.029393
IL
Other
Enumeration date
12/21/2015
Last updated
12/21/2015
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