Provider Demographics
NPI:1992412837
Name:RYAN MCCARTY DDS LLC
Entity type:Organization
Organization Name:RYAN MCCARTY DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:MCCARTY
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:607-972-7705
Mailing Address - Street 1:2600 LE COMPTE LN
Mailing Address - Street 2:
Mailing Address - City:DAVIDSONVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21035-1142
Mailing Address - Country:US
Mailing Address - Phone:607-972-7705
Mailing Address - Fax:
Practice Address - Street 1:5482 MUDDY CREEK RD
Practice Address - Street 2:
Practice Address - City:WEST RIVER
Practice Address - State:MD
Practice Address - Zip Code:20778-2206
Practice Address - Country:US
Practice Address - Phone:410-867-0247
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty