Provider Demographics
NPI:1477008241
Name:TRULBY, RYAN (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:
Last Name:TRULBY
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:257 AZALEA DR
Mailing Address - Street 2:
Mailing Address - City:NEW MILFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07646-2530
Mailing Address - Country:US
Mailing Address - Phone:201-390-0792
Mailing Address - Fax:
Practice Address - Street 1:257 AZALEA DR
Practice Address - Street 2:
Practice Address - City:NEW MILFORD
Practice Address - State:NJ
Practice Address - Zip Code:07646-2530
Practice Address - Country:US
Practice Address - Phone:201-390-0792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-22
Last Update Date:2018-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0597791223X0400X
NJ22DI026474011223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty