Individual
MRS. RYAN WELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDHAP
Contact information
Practice address
11092 ANDERSON STREET, LLU SCHOOL OF DENTISTRY, LOMA LINDA, CA 92350-0001
(909) 558-4613
(909) 558-4192
Mailing address
PO BOX 279, LOMA LINDA, CA 92354-0279
(909) 353-4154
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
HAP785
CA
124Q00000X
Dental Hygienist
RDH 22326
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HAP785
DENTAL HYGIENE BOARD
CA
01
—
RDH 22326
STATE LICENSE
CA
Enumeration date
10/15/2008
Last updated
08/11/2024
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