Provider Demographics
NPI:1366931073
Name:ECKLEY, RYAN PATRICK (DDS)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:PATRICK
Last Name:ECKLEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1234 MADISON LN
Mailing Address - Street 2:
Mailing Address - City:HOCKESSIN
Mailing Address - State:DE
Mailing Address - Zip Code:19707-9417
Mailing Address - Country:US
Mailing Address - Phone:717-580-4920
Mailing Address - Fax:
Practice Address - Street 1:1522 S STATE ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-4950
Practice Address - Country:US
Practice Address - Phone:302-674-1080
Practice Address - Fax:302-674-0775
Is Sole Proprietor?:No
Enumeration Date:2018-05-08
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEG1-00115421223G0001X
NJ22DI027825001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice