Individual
DR. JUSTIN LOUIS RIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
8215 E KEUKA CT, TUCSON, AZ 85715-6808
(520) 336-2286
Mailing address
8215 E KEUKA CT, TUCSON, AZ 85715-6808
(520) 336-2286
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019027934
IL
122300000X
Dentist
8596
AZ
1223G0001X
General Practice Dentistry
Primary
8596
AZ
Other
Enumeration date
09/07/2010
Last updated
08/05/2020
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