Individual
DR. RYAN K EDMUNDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
745 N 500 W STE 102, PROVO, UT 84601-1473
(801) 374-8002
Mailing address
745 N 500 W STE 102, PROVO, UT 84601-1473
(801) 374-8002
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
7670872-9923
UT
Other
Enumeration date
12/24/2007
Last updated
06/10/2010
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