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Organization

RIDGE DENTAL GROUP PLLC

Active
Other names
Ridge Dental and Aesthetics
Organization subpart
No

Provider details

NPI number
Authorized official
KELLI ELLEN VANHOUTEN- GRUBBS (PARTNER)
(870) 238-2600
Entity
Organization

Contact information

Practice address
808 HIGHWAY 64 E, WYNNE, AR 72396-7414
(870) 238-2600
Mailing address
808 HIGHWAY 64 E, WYNNE, AR 72396-7414

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Enumeration date
12/21/2021
Last updated
12/21/2021
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