Provider Demographics
NPI:1477704187
Name:ABBOTT, RYAN ERIC (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:ERIC
Last Name:ABBOTT
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 1:487 OXBOW DR
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:CO
Mailing Address - Zip Code:80601-5372
Mailing Address - Country:US
Mailing Address - Phone:907-299-4715
Mailing Address - Fax:
Practice Address - Street 1:487 OXBOW DR
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:CO
Practice Address - Zip Code:80601-5372
Practice Address - Country:US
Practice Address - Phone:907-299-4715
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-01
Last Update Date:2021-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK13961223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics