Provider Demographics
NPI:1720571151
Name:RYSER, ANDREW STEVEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:STEVEN
Last Name:RYSER
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:BLDG 38801 ACADEMIC DRIVE
Mailing Address - Street 2:SUITE B & C
Mailing Address - City:FORT GORDON
Mailing Address - State:GA
Mailing Address - Zip Code:30905
Mailing Address - Country:US
Mailing Address - Phone:706-787-6927
Mailing Address - Fax:
Practice Address - Street 1:BLDG 38801 ACADEMIC DRIVE
Practice Address - Street 2:SUITE B & C
Practice Address - City:FORT GORDON
Practice Address - State:GA
Practice Address - Zip Code:30905
Practice Address - Country:US
Practice Address - Phone:706-787-6927
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-11
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.025392122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist