Individual
JACOB JOHN RIDL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1717 1ST ST, CHENEY, WA 99004-1903
(509) 235-6241
(509) 235-6218
Mailing address
1717 1ST ST, CHENEY, WA 99004-1903
(509) 235-6241
(509) 235-6218
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE60093486
WA
Other
Enumeration date
07/15/2009
Last updated
07/15/2009
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