Individual
RYAN GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5430 TUTT BLVD, COLORADO SPRINGS, CO 80922-2515
(719) 380-0141
Mailing address
5430 TUTT BLVD, COLORADO SPRINGS, CO 80922-2515
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DEN.00202221
CO
Other
Enumeration date
06/16/2014
Last updated
06/16/2014
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