Individual
DR. RYAN HARTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1632 LEONARD ST NW, GRAND RAPIDS, MI 49504-3950
(616) 460-3838
Mailing address
954 52ND ST SE, KENTWOOD, MI 49508-6004
(616) 724-1780
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901602252
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/10/2023
Last updated
07/01/2024
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