Individual
DR. RYAN ALAN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
400 FAIRVIEW AVE STE 6, PONCA CITY, OK 74601-1910
(580) 765-2589
(580) 762-2199
Mailing address
400 FAIRVIEW AVE STE 6, PONCA CITY, OK 74601-1910
(580) 765-2589
(580) 762-2199
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6592
OK
Other
Enumeration date
06/02/2014
Last updated
06/02/2014
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