Organization
JACOB J. RIDL DDS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB J. RIDL DDS PLLC (DENTIST)
(509) 235-6241
Entity
Organization
Contact information
Practice address
1717 1ST ST, P.O. BOX A, CHENEY, WA 99004-1903
(509) 235-6241
(509) 235-6218
Mailing address
1717 1ST ST, P.O. BOX A, 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
08/11/2016
Last updated
08/11/2016
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