Provider Demographics
NPI:1639308133
Name:DAVIS, RYAN R (DMD)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:R
Last Name:DAVIS
Suffix:
Gender:
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 RYAN DAVIS CT
Mailing Address - Street 2:
Mailing Address - City:BONAIRE
Mailing Address - State:GA
Mailing Address - Zip Code:31005-1104
Mailing Address - Country:US
Mailing Address - Phone:478-922-5882
Mailing Address - Fax:478-922-5910
Practice Address - Street 1:120 RYAN DAVIS CT
Practice Address - Street 2:
Practice Address - City:BONAIRE
Practice Address - State:GA
Practice Address - Zip Code:31005-1104
Practice Address - Country:US
Practice Address - Phone:478-922-5882
Practice Address - Fax:478-922-5910
Is Sole Proprietor?:No
Enumeration Date:2009-07-07
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN013882122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist