Individual
DR. RYAZ ANSARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
483 MIDDLE TPKE W, SUITE 102, MANCHESTER, CT 06040-3863
(860) 649-2272
(860) 649-4538
Mailing address
483 MIDDLE TPKE W, SUITE 102, MANCHESTER, CT 06040-3863
(860) 649-2272
(860) 649-4538
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
009050
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
009050
STATE LICENSE
CT
Enumeration date
07/19/2006
Last updated
10/20/2020
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