Individual
DR. PAIGE COVINGTON RIDDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S., M.S.
Contact information
Practice address
309 SW MARKET ST, LEES SUMMIT, MO 64063-2315
(816) 246-4671
Mailing address
5005 N PIEDRAS ST, EL PASO, TX 79920-5001
(915) 744-6083
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
3816
AR
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
2015012809
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
48834068
—
TX
05
—
77576268
—
TX
05
—
92707564
—
TX
Enumeration date
07/20/2011
Last updated
07/19/2019
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