Individual
DR. JOHN WADE RILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
10 ROUNDTREE ST., WILLISTON, SC 29853-0659
(803) 266-7246
(803) 266-3403
Mailing address
PO BOX 659, WILLISTON, SC 29853-0659
(803) 266-7246
(803) 266-3403
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
Z28211
SC
Other
Enumeration date
01/17/2007
Last updated
07/08/2007
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