Individual
MARK RYAN HUMPHREYS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1523 N MARKET ST, TROY, OH 45373-9767
(937) 335-4630
Mailing address
430 WAYNE ST, VERSAILLES, OH 45380-1356
(937) 638-3852
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30.026157
OH
Other
Enumeration date
05/28/2020
Last updated
05/28/2020
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