Provider Demographics
NPI:1720622954
Name:RYAN C COWAN DDS PC
Entity Type:Organization
Organization Name:RYAN C COWAN DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:COWAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS PC
Authorized Official - Phone:972-415-4359
Mailing Address - Street 1:PO BOX 1017
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:TX
Mailing Address - Zip Code:76645-1017
Mailing Address - Country:US
Mailing Address - Phone:254-582-9555
Mailing Address - Fax:254-582-8477
Practice Address - Street 1:201 OLD BRANDON RD
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:TX
Practice Address - Zip Code:76645-2326
Practice Address - Country:US
Practice Address - Phone:254-582-9555
Practice Address - Fax:254-582-8477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-31
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty