| Dr Michael Ryan Pc | |
|
30 Medical Center Blvd Suite 100 Upland PA 19013-3955 | |
| (610) 872-1355 | |
| (610) 874-2587 |
| Full Name | Dr Michael Ryan Pc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 30 Medical Center Blvd, Upland, Pennsylvania |
| Authorized Official Name and Position | Michael D Ryan (OWNER) |
| Authorized Official Contact | 6108721355 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Michael Ryan Pc 30 Medical Center Blvd Suite 100 Upland PA 19013-3955 Ph: (610) 872-1355 | Dr Michael Ryan Pc 30 Medical Center Blvd Suite 100 Upland PA 19013-3955 Ph: (610) 872-1355 |
| NPI Number | 1437104080 |
|---|---|
| Provider Enumeration Date | 05/23/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437104080 | NPI | - | NPPES |
| 2049879000 | Other | PA | HMO PA GROUP ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | DS016527L (Pennsylvania) | Primary |