Individual
DR. DOUGLAS W RIETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
208 S PARK ST, WALLA WALLA, WA 99362-3247
(509) 522-0499
(509) 522-0593
Mailing address
208 S PARK ST, WALLA WALLA, WA 99362-3247
(509) 522-0499
(509) 522-0593
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00006530
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00762606
UNITED CONCORDIA
WA
05
—
5017033
—
WA
01
—
56530
WASHINGTON DENTAL SVC
WA
Enumeration date
11/06/2006
Last updated
07/08/2007
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