Provider Demographics
NPI:1427111814
Name:SMITH, DANA RYAN (DDS)
Entity type:Individual
Prefix:MRS
First Name:DANA
Middle Name:RYAN
Last Name:SMITH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1640 CHARLES PLACE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502
Mailing Address - Country:US
Mailing Address - Phone:785-537-8484
Mailing Address - Fax:785-537-2281
Practice Address - Street 1:1640 CHARLES PLACE
Practice Address - Street 2:SUITE 101
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502
Practice Address - Country:US
Practice Address - Phone:785-537-8484
Practice Address - Fax:785-537-2281
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS60055122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist