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General NPI Number Information
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NPI Number | 1841395845
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Entity Type | Organization
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Legal Business Name | RIDGWAY & RIDGWAY DDS INC
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6329 ORAM STREET
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City | DALLAS
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State | TX
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Zip | 75214
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Country | US
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Telephone | 214-823-1638
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Fax | 214-823-1169
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Provider Business Mailing Address
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Address Line | 6329 ORAM STREET
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City | DALLAS
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State | TX
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Zip | 75214
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Country | US
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Telephone | 214-823-1638
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Fax | 214-823-1169
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Authorized Official
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Title or Position | DENTIST
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Name | DR. RICHARD ALLEN BEADLE JR.
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Credential | DDS
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Telephone | 214-823-1638
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 10075
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 13060
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License Number State | TX
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