Individual
RYAN DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2651 W SOUTH JORDAN PKWY STE 201, SOUTH JORDAN, UT 84095-8966
(801) 254-2700
Mailing address
801 E SIMPSON AVE APT A, SALT LAKE CITY, UT 84106-1819
(801) 831-8629
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DEN.00204518
CO
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
13153333-9926
UT
Other
Enumeration date
11/24/2020
Last updated
09/16/2024
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