Individual
DR. PETER RIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1306 WASHINGTON ST, WEST NEWTON, MA 02465-2027
(617) 527-1600
(617) 527-8469
Mailing address
1306 WASHINGTON ST, WEST NEWTON, MA 02465-2027
(617) 527-1600
(617) 527-8469
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
12189
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
X10267
BLUE CROSS BLUE SHIELD
MA
Enumeration date
10/04/2006
Last updated
07/08/2007
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