Provider Demographics
NPI:1083840748
Name:STANGER, RYAN T (DMD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:T
Last Name:STANGER
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 1:6601 S RURAL RD
Mailing Address - Street 2:STE #120
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-3747
Mailing Address - Country:US
Mailing Address - Phone:480-456-0821
Mailing Address - Fax:
Practice Address - Street 1:6601 S RURAL RD
Practice Address - Street 2:STE #120
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-3747
Practice Address - Country:US
Practice Address - Phone:480-456-0821
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-08
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD7754122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist