| NPI | 1669608741 |
|---|---|
| Doing Business As | RIDGE KIDS DENTAL |
| Entity Type | Organization |
| Authorized Contact | JOHN HARTLEY PUCKETT Owner 870-236-5888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AR 3406) |
| Enumeration Date | 2009-06-03 |
| Last Update Date | 2015-03-17 |