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Organization
RIDGE DENTAL LTD
Active
Organization
RIDGE DENTAL LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER JOHN GREEN DDS (OWNER)
(708) 424-0052
Entity
Organization
Contact information
Practice address
6422 W 107TH ST, CHICAGO RIDGE, IL 60415
(708) 424-0052
(708) 424-0055
Mailing address
6422 W 107TH ST, CHICAGO RIDGE, IL 60415
(708) 424-0052
(708) 424-0055
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
IL
Other
Enumeration date
02/16/2007
Last updated
08/22/2020
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