| Lawrence P. Ryan, Dds, Md, Pc | |
|
11 S Main St Suite 1 Marlborough CT 06447-1553 | |
| (860) 295-8780 | |
| (860) 295-0875 |
| Full Name | Lawrence P. Ryan, Dds, Md, Pc |
|---|---|
| Speciality | Dentist |
| Location | 11 S Main St, Marlborough, Connecticut |
| Authorized Official Name and Position | Lawrence P Ryan (OWNER) |
| Authorized Official Contact | 8602958780 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lawrence P. Ryan, Dds, Md, Pc 11 S Main St Suite 1 Marlborough CT 06447-1553 Ph: (860) 295-8780 | Lawrence P. Ryan, Dds, Md, Pc 11 S Main St Suite 1 Marlborough CT 06447-1553 Ph: (860) 295-8780 |
| NPI Number | 1427297654 |
|---|---|
| Provider Enumeration Date | 02/11/2009 |
| Last Update Date | 02/11/2009 |
| Medicare PECOS PAC ID | 7618025602 |
|---|---|
| Medicare Enrollment ID | O20090430000488 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427297654 | NPI | - | NPPES |
| 007529 | Other | CT | CONNECTICARE INSURANCE |
| 0418117 | Other | PA | CIGNA |
| 204861 | Other | TN | CIGNA DENTAL HEALTH |
| 020007529CT07 | Other | CT | ANTHEM BLUE CROSS |
| 207529 | Other | NJ | DELTA DENTAL |
| 4332423 | Other | TX | AETNA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 007529 (Connecticut) | Primary |
| Provider Name | Lawrence P Ryan |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1205961042 PECOS PAC ID: 0547318537 Enrollment ID: I20090430000478 |