Provider Demographics
NPI:1649361882
Name:RYAN, THOMAS N (DDS)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:N
Last Name:RYAN
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 1:17 N HARDING RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43209-1583
Mailing Address - Country:US
Mailing Address - Phone:614-235-8612
Mailing Address - Fax:614-235-4555
Practice Address - Street 1:17 N HARDING RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43209-1583
Practice Address - Country:US
Practice Address - Phone:614-235-8612
Practice Address - Fax:614-235-4555
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH12755122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist