Individual
DR. JON SCOTT RYDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
3435 SPRING ST, DAVENPORT, IA 52807-2142
(563) 355-6492
(563) 355-2589
Mailing address
3435 SPRING ST, DAVENPORT, IA 52807-2142
(563) 355-6492
(563) 355-2589
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
07837
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0169813
—
IA
01
—
59851
BLUECROSS BLUE SHIELD
IA
Enumeration date
02/07/2007
Last updated
07/08/2007
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