Individual
JOHN DAVID RIDELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
901 MENOHER BLVD, JOHNSTOWN, PA 15905
(814) 536-5646
(814) 536-1774
Mailing address
901 MENOHER BLVD, JOHNSTOWN, PA 15905
(814) 536-5646
(814) 536-1774
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
026351
PA
122300000X
Dentist
BR1727215
PA
Other
Enumeration date
09/20/2006
Last updated
07/08/2007
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