Individual
MARK INGRAM RYDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
521 PARNASSUS AVE, ROOM C-628, SAN FRANCISCO, CA 94143-2206
(415) 476-1699
(415) 502-4990
Mailing address
521 PARNASSUS AVE, ROOM C-628, SAN FRANCISCO, CA 94143-2206
(415) 476-1699
(415) 502-4990
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
CA51446
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CA51446
CALIFORNIA DENTAL LICENCE
CA
Enumeration date
11/02/2006
Last updated
07/08/2007
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