Individual
DR. RYAN RICHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D , M.S
Contact information
Practice address
645 BEAVER RUIN RD NW, LILBURN, GA 30047-3401
(770) 448-8882
Mailing address
645 BEAVER RUIN RD NW, LILBURN, GA 30047-3401
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DNO1436
GA
Other
Enumeration date
11/13/2013
Last updated
11/13/2013
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