Provider Demographics
NPI:1841458718
Name:RYERSON, JAMES ALAN (DMD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ALAN
Last Name:RYERSON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1013 AVALON AVE
Mailing Address - Street 2:
Mailing Address - City:MUSCLE SHOALS
Mailing Address - State:AL
Mailing Address - Zip Code:35661-2401
Mailing Address - Country:US
Mailing Address - Phone:256-381-2100
Mailing Address - Fax:256-381-4844
Practice Address - Street 1:1013 AVALON AVE
Practice Address - Street 2:
Practice Address - City:MUSCLE SHOALS
Practice Address - State:AL
Practice Address - Zip Code:35661-2401
Practice Address - Country:US
Practice Address - Phone:256-381-2100
Practice Address - Fax:256-381-4844
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-28
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2974122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL36712OtherBCBS OF ALABAMA