Individual
DR. RYAN KEITH DAGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
5180 PARK AVE STE 310, MEMPHIS, TN 38119-3531
(901) 685-1152
Mailing address
5180 PARK AVE STE 310, MEMPHIS, TN 38119-3531
(901) 685-1152
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9498
TN
1223G0001X
General Practice Dentistry
9498
TN
390200000X
Student in an Organized Health Care Education/Training Program
9498
TN
Other
Enumeration date
06/25/2012
Last updated
10/26/2024
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