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Individual

DR. WALTER RANDY RIDGWAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
302 NORTH HUGHES STREET, HUNTSVILLE, AR 72740-0605
(479) 738-6920
(479) 738-2957
Mailing address
P.O. BOX 605, HUNTSVILLE, AR 72740-0605
(479) 738-6920
(479) 738-2957

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2412
AR

Other

Enumeration date
09/25/2006
Last updated
07/08/2007
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