Provider Demographics
NPI:1952074130
Name:SLOAN, GEORGE RYAN (DDS, MDS)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:RYAN
Last Name:SLOAN
Suffix:
Gender:M
Credentials:DDS, MDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8263 GRAYCE DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:38671-7052
Mailing Address - Country:US
Mailing Address - Phone:505-414-2889
Mailing Address - Fax:
Practice Address - Street 1:1601 LAKESIDE DR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-3464
Practice Address - Country:US
Practice Address - Phone:775-323-3574
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-26
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV74761223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics