Organization
GRILLZ
Active
Other names
Ridgecrest Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN MICHAEL LEININGER DMD (GENERAL DENTIST)
(208) 936-9244
Entity
Organization
Contact information
Practice address
4513 ENTERPRISE WAY, CALDWELL, ID 83605
(208) 936-9244
Mailing address
4513 ENTERPRISE WAY, CALDWELL, ID 83605
(208) 936-9244
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/18/2021
Last updated
10/18/2021
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