Provider Demographics
NPI:1255725206
Name:CENTINI, RYAN (DVM)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:
Last Name:CENTINI
Suffix:
Gender:M
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:726 PRESERVATION ST
Mailing Address - Street 2:
Mailing Address - City:FAIRBORN
Mailing Address - State:OH
Mailing Address - Zip Code:45324-4492
Mailing Address - Country:US
Mailing Address - Phone:801-712-0989
Mailing Address - Fax:
Practice Address - Street 1:726 PRESERVATION ST
Practice Address - Street 2:
Practice Address - City:FAIRBORN
Practice Address - State:OH
Practice Address - Zip Code:45324-4492
Practice Address - Country:US
Practice Address - Phone:801-712-0989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-26
Last Update Date:2020-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHVET.11467246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other