Individual
REID KETCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
818 W 6TH ST STE 3, THE DALLES, OR 97058-1147
(541) 296-9134
Mailing address
818 W 6TH ST STE 3, THE DALLES, OR 97058-1147
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D9719
OR
1223G0001X
General Practice Dentistry
DE9616
WA
Other
Enumeration date
10/14/2015
Last updated
10/14/2015
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