Individual
DR. MARK J RIDENOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1875 W POINTE DR, OSHKOSH, WI 54902-4174
(920) 231-4600
Mailing address
1875 W POINTE DR, OSHKOSH, WI 54902-4174
(920) 231-4600
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
6044-15
WI
Other
Enumeration date
07/06/2007
Last updated
07/05/2011
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