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Organization
JACOB RIDER DDS LLC
Active
Organization
JACOB RIDER DDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB RIDER (OWNER DENTIST)
(317) 457-0338
Entity
Organization
Contact information
Practice address
2437 HARBOR BLVD, VENTURA, CA 93001-3904
(805) 804-5590
Mailing address
702 CEDAR PL, VENTURA, CA 93001-1920
(317) 457-0338
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/16/2024
Last updated
08/16/2024
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