| NPI | 1972263739 |
|---|---|
| Doing Business As | RIDGE DENTAL AND AESTHETICS |
| Entity Type | Organization |
| Authorized Contact | KELLI ELLEN VANHOUTEN- GRUBBS Partner 870-238-2600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2021-12-21 |
| Last Update Date | 2021-12-21 |