Organization
CONWAY VILLAGE DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE GERARD RYAN JR. DDS (OWNER)
(603) 447-6707
Entity
Organization
Contact information
Practice address
7 GREENWOOD AVE, SUITE 3, CONWAY, NH 03818-6130
(603) 447-6707
(603) 447-8376
Mailing address
7 GREENWOOD AVE, SUITE 3, CONWAY, NH 03818-6130
(603) 447-6707
(603) 447-8376
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
139600000
—
ME
05
—
99002725
—
NH
Enumeration date
06/10/2008
Last updated
06/10/2008
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