Provider Demographics
NPI:1215524111
Name:RYAN T. GRIFFITH, DMD, PA
Entity type:Organization
Organization Name:RYAN T. GRIFFITH, DMD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIFFITH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:919-755-3450
Mailing Address - Street 1:615 SAINT MARYS ST
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27605-1703
Mailing Address - Country:US
Mailing Address - Phone:919-755-3450
Mailing Address - Fax:919-755-3474
Practice Address - Street 1:615 SAINT MARYS ST
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27605-1703
Practice Address - Country:US
Practice Address - Phone:919-755-3450
Practice Address - Fax:919-755-3474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-25
Last Update Date:2020-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental