Provider Demographics
NPI:1407970056
Name:SANDERS, RYAN G (DDS)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:G
Last Name:SANDERS
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 1:28 W PEORIA
Mailing Address - Street 2:
Mailing Address - City:PAOLA
Mailing Address - State:KS
Mailing Address - Zip Code:66071
Mailing Address - Country:US
Mailing Address - Phone:913-294-5377
Mailing Address - Fax:913-294-5663
Practice Address - Street 1:28 W PEORIA
Practice Address - Street 2:
Practice Address - City:PAOLA
Practice Address - State:KS
Practice Address - Zip Code:66071
Practice Address - Country:US
Practice Address - Phone:913-294-5377
Practice Address - Fax:913-294-5663
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS60240122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist