Individual
DR. RYAN HOLMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
9973 W LILLYWOOD DR, BOISE, ID 83709
(208) 918-3384
Mailing address
10400 W OVERLAND RD # 314, BOISE, ID 83709-1433
(208) 918-3384
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
61915
CA
1223X0008X
Oral and Maxillofacial Radiology Dentistry
061449
NY
1223X0008X
Oral and Maxillofacial Radiology Dentistry
Primary
D-4916-RD
ID
Other
Enumeration date
09/17/2012
Last updated
04/02/2021
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