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Individual

DR. DAVID ERWIN RIDDICK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DENTIST

Contact information

Practice address
801 W TRIMBLE AVE, BERRYVILLE, AR 72616-5101
(870) 423-3832
(870) 423-3832
Mailing address
PO BOX 365, BERRYVILLE, AR 72616-0365
(870) 423-3832
(870) 423-2995

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3264
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5T911
BLUE CROSS BLUE SHIELD
AR
01
974643
UNITED CONCORDIA BC/BS
AR
Enumeration date
08/15/2006
Last updated
07/09/2007
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