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Individual

PAUL RILEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
108 S MAPLE ST STE C, RIDGELAND, MS 39157-2305
(769) 567-2555
Mailing address
108 S MAPLE ST STE C, RIDGELAND, MS 39157-2305
(769) 567-2555

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
2359-87
MS
1223X2210X
Orofacial Pain Dentistry
Primary
OP-6042-23
MS

Other

Enumeration date
07/31/2006
Last updated
12/28/2023
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