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Individual

DR. MARK RALPH RYSER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.M.D., M.D.

Contact information

Practice address
6287 S REDWOOD RD STE 103, TAYLORSVILLE, UT 84123-6653
(801) 261-2444
Mailing address
6287 S REDWOOD RD STE 103, TAYLORSVILLE, UT 84123-6653
(801) 261-2444

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
6540390-9924
UT
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
6540390-1205
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1057428
LA
Enumeration date
04/02/2007
Last updated
04/16/2008
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