Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 5379 | LA |
NPI | 1447383567 |
---|---|
Provider Name | Dr. Ryan Dennis Ward |
First Address | Monroe, LA 71201-3050 |
Second Address | Monroe, LA 71201-3050 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2007 |
Last Update Date | 08/07/2007 |