Individual
RYAN O'MALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
419 SE MAIN ST STE 100, SIMPSONVILLE, SC 29681-2674
(864) 962-4140
(864) 962-4142
Mailing address
419 SE MAIN ST STE 100, SIMPSONVILLE, SC 29681-2674
(864) 962-4140
(864) 962-4142
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DGD.6921 GD
SC
Other
Enumeration date
07/21/2010
Last updated
05/27/2016
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