Organization
DR MICHAEL RYAN PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL D RYAN DDS (OWNER)
(610) 872-1355
Entity
Organization
Contact information
Practice address
30 MEDICAL CENTER BLVD, SUITE 100, UPLAND, PA 19013-3955
(610) 872-1355
(610) 874-2587
Mailing address
30 MEDICAL CENTER BLVD, SUITE 100, UPLAND, PA 19013-3955
(610) 872-1355
(610) 874-2587
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DS016527L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2049879000
HMO PA GROUP ID
PA
Enumeration date
05/23/2006
Last updated
08/22/2020
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