Provider Demographics
NPI:1619389764
Name:PLATT, RYAN J (DDS)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:J
Last Name:PLATT
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 1:6040 WILMINGTON PIKE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45459-7006
Mailing Address - Country:US
Mailing Address - Phone:937-848-3024
Mailing Address - Fax:937-848-3448
Practice Address - Street 1:6040 WILMINGTON PIKE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459-7006
Practice Address - Country:US
Practice Address - Phone:937-848-3024
Practice Address - Fax:937-848-3448
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-23
Last Update Date:2014-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.024231122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist