Provider Demographics
NPI:1053537571
Name:VANMOORLEHEM, RYAN FREDERICK (DMD)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:FREDERICK
Last Name:VANMOORLEHEM
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:826 N 100 E
Mailing Address - Street 2:SUITE 3
Mailing Address - City:SPANISH FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84660-1241
Mailing Address - Country:US
Mailing Address - Phone:801-504-6070
Mailing Address - Fax:801-504-6068
Practice Address - Street 1:826 N 100 E
Practice Address - Street 2:SUITE 3
Practice Address - City:SPANISH FORK
Practice Address - State:UT
Practice Address - Zip Code:84660-1241
Practice Address - Country:US
Practice Address - Phone:801-504-6070
Practice Address - Fax:801-504-6068
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT51719891223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics