Individual
DR. RYAN MICHAEL JACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.
Contact information
Practice address
8580 SCARBOROUGH DR, #200, COLORADO SPRINGS, CO 80920-7583
(719) 282-6600
Mailing address
8580 SCARBOROUGH DR, #200, COLORADO SPRINGS, CO 80920-7583
(719) 282-6600
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
10046
CO
1223E0200X
Endodontics
D-3585
ID
1223E0200X
Endodontics
DN18177
FL
Other
Enumeration date
01/27/2006
Last updated
06/27/2010
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