Lawrence P. Ryan, Dds, Md, Pc | |
11 S Main St Suite 1 Marlborough CT 06447-1553 | |
(860) 295-8780 | |
(860) 295-0875 |
Full Name | Lawrence P. Ryan, Dds, Md, Pc |
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Speciality | Dentist |
Location | 11 S Main St, Marlborough, Connecticut |
Authorized Official Name and Position | Lawrence P Ryan (OWNER) |
Authorized Official Contact | 8602958780 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Lawrence P. Ryan, Dds, Md, Pc 11 S Main St Suite 1 Marlborough CT 06447-1553 Ph: (860) 295-8780 | Lawrence P. Ryan, Dds, Md, Pc 11 S Main St Suite 1 Marlborough CT 06447-1553 Ph: (860) 295-8780 |
NPI Number | 1427297654 |
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Provider Enumeration Date | 02/11/2009 |
Last Update Date | 02/11/2009 |
Medicare PECOS PAC ID | 7618025602 |
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Medicare Enrollment ID | O20090430000488 |
Identifier | Type | State | Issuer |
---|---|---|---|
1427297654 | NPI | - | NPPES |
007529 | Other | CT | CONNECTICARE INSURANCE |
0418117 | Other | PA | CIGNA |
204861 | Other | TN | CIGNA DENTAL HEALTH |
020007529CT07 | Other | CT | ANTHEM BLUE CROSS |
207529 | Other | NJ | DELTA DENTAL |
4332423 | Other | TX | AETNA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223S0112X | Dentist - Oral And Maxillofacial Surgery | 007529 (Connecticut) | Primary |
Provider Name | Lawrence P Ryan |
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Provider Type | Practitioner - Oral Surgery |
Provider Identifiers | NPI Number: 1205961042 PECOS PAC ID: 0547318537 Enrollment ID: I20090430000478 |