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Individual

DR. RYAN L DIQUATTRO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
704 SOUTH MEADOW STREET, PAYSON, AZ 85541
(928) 474-5231
(928) 474-5231
Mailing address
704 S MEADOW ST, PAYSON, AZ 85541-5341

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7758
AZ

Other

Enumeration date
06/16/2009
Last updated
04/08/2010
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