Individual
DR. RYAN N VAN ALFEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, PLC
Contact information
Practice address
483 S RIVERSHORE LN STE 102, EAGLE, ID 83616-4978
(208) 938-2100
(208) 938-0676
Mailing address
483 S RIVERSHORE LN STE 102, EAGLE, ID 83616-4978
(208) 938-2100
(208) 938-0676
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-3611
ID
Other
Enumeration date
08/17/2006
Last updated
07/08/2007
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