Provider Demographics
NPI:1891864252
Name:WOODMAN, RYAN C (DMD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:C
Last Name:WOODMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3320 SISKEY PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-3223
Mailing Address - Country:US
Mailing Address - Phone:704-708-4402
Mailing Address - Fax:
Practice Address - Street 1:3320 SISKEY PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-3223
Practice Address - Country:US
Practice Address - Phone:704-708-4402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7909122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist