Provider Demographics
NPI:1528139003
Name:MCNEIL, RYAN SCOTT (DDS)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:SCOTT
Last Name:MCNEIL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6895 S 900 E
Mailing Address - Street 2:SUITE B
Mailing Address - City:MIDVALE
Mailing Address - State:UT
Mailing Address - Zip Code:84047-1758
Mailing Address - Country:US
Mailing Address - Phone:801-255-4555
Mailing Address - Fax:801-255-4455
Practice Address - Street 1:6895 S 900 E
Practice Address - Street 2:SUITE B
Practice Address - City:MIDVALE
Practice Address - State:UT
Practice Address - Zip Code:84047-1758
Practice Address - Country:US
Practice Address - Phone:801-255-4555
Practice Address - Fax:801-255-4455
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT373389-9923122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist