Individual
TAYLOR RIDENOUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
318 W BROADWAY ST, SPIRO, OK 74959-2422
(918) 962-2466
Mailing address
19428 MIZE LN, SPIRO, OK 74959-4342
(479) 462-5233
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7878
OK
Other
Enumeration date
07/01/2024
Last updated
07/01/2024
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