Ridge Dental Group Pllc

NPI #1972263739 in Wynne, Arkansas

Provider Information

NPI Number: 1972263739
Entity Type: Organization
Organization Name: Ridge Dental Group Pllc
Primary Specialty: Clinic/Center - Dental
Enumeration Date: Dec 21, 2021
Last Updated: Dec 21, 2021

Practice Location

Address: 808 HIGHWAY 64 E
City: Wynne
State: Arkansas
ZIP Code: 72396-7414
Phone: (870) 238-2600

Authorized Official

Name: KELLI ELLEN VANHOUTEN- GRUBBS
Title: PARTNER
Phone: (870) 238-2600

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Dental — Dental	261QD0000X	Primary

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