IndividualActive
Ryan Edmunds, DDS
NPI 1467636688 · Periodontics · Provo, UT
Provider details
- NPI number
- 1467636688
- Entity type
- Individual
- Primary specialty
- PeriodonticsDental Providers
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- No
- License
- 7670872-9923 (UT)
Specialties & taxonomies
Dental Providers
Practice location
745 N 500 W Ste 102
Provo, UT 84601-1473
Phone: (801) 374-8002
Approximate (ZIP-level) locationGet directions
Mailing address
745 N 500 W Ste 102
Provo, UT 84601-1473
Registry dates
- Enumerated
- 2007-12-24
- Last updated
- 2010-06-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.