Provider Demographics
NPI:1023490273
Name:TREML, RYAN F (DMD)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:F
Last Name:TREML
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 1:8600 NICOLLET AVENUE
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55420-2824
Mailing Address - Country:US
Mailing Address - Phone:952-541-2888
Mailing Address - Fax:952-541-2889
Practice Address - Street 1:8600 NICOLLET AVENUE
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55420-2824
Practice Address - Country:US
Practice Address - Phone:952-541-2888
Practice Address - Fax:952-541-2889
Is Sole Proprietor?:No
Enumeration Date:2015-06-24
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MND13733122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program