Individual
DR. ANN E. RILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
407 DAISY DR, SUITE A, TAHLEQUAH, OK 74464
(918) 431-0202
(918) 431-0203
Mailing address
PO BOX 751, HULBERT, OK 74441
(918) 772-3390
(918) 772-3638
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5760
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5760
BOARD OF DDS STATE OF OK
OK
Enumeration date
12/14/2006
Last updated
07/08/2007
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