Provider Demographics
NPI:1457735201
Name:DAHLE, RYAN (DMD)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:DAHLE
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 1:1911 NORWOOD ST
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75092-4556
Mailing Address - Country:US
Mailing Address - Phone:018-232-5628
Mailing Address - Fax:
Practice Address - Street 1:420 N RUSK ST
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-5858
Practice Address - Country:US
Practice Address - Phone:903-892-1052
Practice Address - Fax:903-892-0607
Is Sole Proprietor?:No
Enumeration Date:2015-07-10
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31031122300000X
UT5450784122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist