Provider Demographics
NPI:1457705006
Name:RYAN ROSS DDS
Entity type:Organization
Organization Name:RYAN ROSS DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:STEEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-541-5800
Mailing Address - Street 1:11545 LOS OSOS VALLEY RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93405-6470
Mailing Address - Country:US
Mailing Address - Phone:805-541-5800
Mailing Address - Fax:805-541-2083
Practice Address - Street 1:11545 LOS OSOS VALLEY RD
Practice Address - Street 2:SUITE A
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93405-6470
Practice Address - Country:US
Practice Address - Phone:805-541-5800
Practice Address - Fax:805-541-2083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-20
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty