Provider Demographics
NPI:1063669398
Name:TAMBURRINO, RYAN KENNETH (DMD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:KENNETH
Last Name:TAMBURRINO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 PRINCETON HIGHTSTOWN RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:PRINCETON JUNCTION
Mailing Address - State:NJ
Mailing Address - Zip Code:08550-1120
Mailing Address - Country:US
Mailing Address - Phone:609-799-4628
Mailing Address - Fax:
Practice Address - Street 1:61 PRINCETON HIGHTSTOWN RD
Practice Address - Street 2:SUITE 1
Practice Address - City:PRINCETON JUNCTION
Practice Address - State:NJ
Practice Address - Zip Code:08550-1120
Practice Address - Country:US
Practice Address - Phone:609-799-4628
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-18
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0369691223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics