Provider Demographics
NPI:1033407903
Name:MEHRER, RYAN DENNIS (DDS)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:DENNIS
Last Name:MEHRER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 PRESERVE AVE E
Mailing Address - Street 2:APT #7308
Mailing Address - City:PORT ROYAL
Mailing Address - State:SC
Mailing Address - Zip Code:29935-1686
Mailing Address - Country:US
Mailing Address - Phone:248-214-4941
Mailing Address - Fax:
Practice Address - Street 1:MCRD PARRIS ISLAND
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:AA
Practice Address - Zip Code:29905
Practice Address - Country:US
Practice Address - Phone:843-228-3500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-13
Last Update Date:2011-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901020451122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist