Individual
DR. RYAN GARDINER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD, MSD
Contact information
Practice address
3250 TRINITY DR, LOS ALAMOS, NM 87544-2226
(505) 662-4555
Mailing address
3250 TRINITY DR, LOS ALAMOS, NM 87544-2226
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DD4890
NM
Other
Enumeration date
07/18/2018
Last updated
07/18/2018
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