MARTIN RYAN

CHICAGO, IL
NPI1124722384
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy122300000X Dentist
(Licence: IL  019.034314)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2023-03-29
Last Update Date2023-06-21
Business Address
MARTIN RYAN
811 W WELLINGTON AVE
CHICAGO, IL 60657-5123
Phone number: 773-871-1461
Mailing Address
MARTIN RYAN
811 W WELLINGTON AVE
CHICAGO, IL 60657-5123
Phone number: