Individual
DR. RYAN WILLIAM TIETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
744 RYAN DR, HUDSON, WI 54016-7979
(715) 386-5400
Mailing address
444 WHITETAIL PASS, HUDSON, WI 54016-7748
(715) 808-0404
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6128-015
WI
122300000X
Dentist
D11962
MN
Other
Enumeration date
10/13/2005
Last updated
09/15/2009
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