Individual
DR. RYAN GOERGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
4055 LINDELL BLVD, SAINT LOUIS, MO 63108-3201
(314) 535-7701
Mailing address
3143 EVERGLADE AVE, WOODRIDGE, IL 60517-3316
(630) 291-0957
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2014038355
MO
Other
Enumeration date
10/29/2014
Last updated
01/15/2016
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