Organization
RYAN K AUSTIN, DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN AUSTIN (OWNER)
(801) 399-3701
Entity
Organization
Contact information
Practice address
5742 S 1475 E STE 100, SOUTH OGDEN, UT 84403-4857
(801) 399-3701
Mailing address
5742 S 1475 E STE 100, SOUTH OGDEN, UT 84403-4857
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
9105773
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1629205034
NPI
TN
Enumeration date
07/07/2015
Last updated
07/07/2015
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