Provider Demographics
NPI:1679917405
Name:RYLL, DENNIS LAWRENCE (MD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:LAWRENCE
Last Name:RYLL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:390 S WOODS MILL RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-3626
Mailing Address - Country:US
Mailing Address - Phone:314-503-4196
Mailing Address - Fax:
Practice Address - Street 1:390 S WOODS MILL RD
Practice Address - Street 2:SUITE 250
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-3626
Practice Address - Country:US
Practice Address - Phone:314-503-4196
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-23
Last Update Date:2013-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR7627207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology