Individual
RYAN JAMES CANADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
3500 S LAKEPORT ST, SIOUX CITY, IA 51106-4516
(712) 276-5547
Mailing address
3050 VALLEY DR, SIOUX CITY, IA 51104-4074
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
6109
NV
122300000X
Dentist
6998
NE
1223G0001X
General Practice Dentistry
Primary
09501
IA
Other
Enumeration date
09/09/2011
Last updated
04/11/2019
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