Provider Demographics
NPI:1780894923
Name:CABLE, RYAN
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:CABLE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2560 SHERIDAN BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80214-3011
Mailing Address - Country:US
Mailing Address - Phone:303-477-7700
Mailing Address - Fax:
Practice Address - Street 1:2560 SHERIDAN BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80214-3011
Practice Address - Country:US
Practice Address - Phone:303-477-7700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8610122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist