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General NPI Number Information
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NPI Number | 1073137741
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Entity Type | Organization
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Legal Business Name | OASIS DENTAL RIDGEFIELD
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Dates
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Enumeration Date | 05/29/2020
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Last Update Date | 06/01/2020
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Provider Practice Location Address
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Address Line | 11 S. 47TH AVE. SUITE 101
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City | RIDGEFILED
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State | WA
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Zip | 98642
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Country | US
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Telephone | 360-727-0355
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Fax |
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Provider Business Mailing Address
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Address Line | 11 S. 47TH AVE. SUITE 101
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City | RIDGEFILED
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State | WA
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Zip | 98642
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Country | US
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Telephone | 360-727-0355
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. MATTHEW C ALDRIDGE
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Credential | DMD
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Telephone | 360-727-0335
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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