Individual
KEVIN P. RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS.
Contact information
Practice address
5006 DODGE ST, OMAHA, NE 68132-2920
(402) 554-1333
Mailing address
5006 DODGE ST, OMAHA, NE 68132-2920
(402) 554-1333
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5223
NE
1223G0001X
General Practice Dentistry
13778
MO
Other
Enumeration date
02/01/2007
Last updated
09/05/2012
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