Individual
DR. CRAIG MARTIN RIRIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S. M.S.D.
Contact information
Practice address
3610 N. UNIVERSITY AVE., 150, PROVO, UT 84604
(801) 356-2226
Mailing address
3610 N UNIVERSITY AVE, 150, PROVO, UT 84604-4437
(801) 356-2226
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
23082
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23082
STATE LICENSE NUMBER
CA
Enumeration date
05/16/2007
Last updated
07/08/2007
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