Provider Demographics
NPI:1083993216
Name:RANEY, MATTHEW RICK (DDS)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:RICK
Last Name:RANEY
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 1:1001 EAGLE VIEW DRIVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:WY
Mailing Address - Zip Code:82834
Mailing Address - Country:US
Mailing Address - Phone:307-684-2158
Mailing Address - Fax:
Practice Address - Street 1:1001 EAGLE VIEW DRIVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:WY
Practice Address - Zip Code:82834
Practice Address - Country:US
Practice Address - Phone:307-684-2158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-05
Last Update Date:2011-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY1286122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist