Individual
DR. ERIC JAMES ETHERIDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
10800 E 77TH TER, RAYTOWN, MO 64138-2331
(816) 358-1122
(816) 358-7853
Mailing address
10800 E 77TH TER, RAYTOWN, MO 64138-2331
(816) 358-1122
(816) 358-7853
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2010016169
MO
Other
Enumeration date
07/26/2010
Last updated
09/15/2014
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