Individual
NICK RIDENHOUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
15991 MANCHESTER RD, ELLISVILLE, MO 63011-2446
(636) 227-2580
Mailing address
15991 MANCHESTER RD, ELLISVILLE, MO 63011-2446
(636) 227-2580
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
019033253
IL
1223G0001X
General Practice Dentistry
Primary
2021017794
MO
Other
Enumeration date
05/19/2021
Last updated
06/24/2021
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