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Organization

LAWRENCE P. RYAN, DDS, MD, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LAWRENCE P RYAN DDS, MD (OWNER)
(860) 295-8780
Entity
Organization

Contact information

Practice address
11 S MAIN ST, SUITE 1, MARLBOROUGH, CT 06447-1553
(860) 295-8780
(860) 295-0875
Mailing address
11 S MAIN ST, SUITE 1, MARLBOROUGH, CT 06447-1553
(860) 295-8780
(860) 295-0875

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
007529
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
007529
CONNECTICARE INSURANCE
CT
01
020007529CT07
ANTHEM BLUE CROSS
CT
01
0418117
CIGNA
PA
01
204861
CIGNA DENTAL HEALTH
TN
01
207529
DELTA DENTAL
NJ
01
4332423
AETNA
TX
Enumeration date
02/11/2009
Last updated
02/11/2009
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