Individual
RYAN K AUSTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S., P.C.
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
(801) 399-3701
(801) 399-3702
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
9105773
UT
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
9657
TN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/12/2009
Last updated
10/17/2016
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