Provider Demographics
NPI:1629119219
Name:DR. RYLAND M. HARWOOD DDS PC
Entity Type:Organization
Organization Name:DR. RYLAND M. HARWOOD DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RYLAND
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:HARWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:503-623-2389
Mailing Address - Street 1:197 SE WASHINGTON ST
Mailing Address - Street 2:PO BOX 832
Mailing Address - City:DALLAS
Mailing Address - State:OR
Mailing Address - Zip Code:97338-2826
Mailing Address - Country:US
Mailing Address - Phone:503-623-2389
Mailing Address - Fax:
Practice Address - Street 1:197 SE WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:OR
Practice Address - Zip Code:97338-2826
Practice Address - Country:US
Practice Address - Phone:503-623-2389
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR45241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty