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Organization
JACOB J. RIDL DDS PLLC
Active
Organization
JACOB J. RIDL DDS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB J. RIDL DDS PLLC (DENTIST)
(509) 235-6241
Entity
Organization
Contact information
Practice address
1717 1ST ST, P.O. BOX A, CHENEY, WA 99004-1903
(509) 235-6241
(509) 235-6218
Mailing address
1717 1ST ST, P.O. BOX A, CHENEY, WA 99004-1903
(509) 235-6241
(509) 235-6218
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE60093486
WA
Other
Enumeration date
08/11/2016
Last updated
08/11/2016
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