MEDICARE: ROBERT L. RIPLEY, DDS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center	37278	CA

General Provider Information

NPI Number	:	1679991780
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT L. RIPLEY, DDS, INC.

Provider Business Mailing Address
First Line	:	1473 LIVE OAK BLVD
Second Line	:
City	:	YUBA CITY
State	:	CA
Zip	:	95991-2920
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1473 LIVE OAK BLVD
Second Line	:
City	:	YUBA CITY
State	:	CA
Zip	:	95991-2920
Country	:	US
Telephone Number	:	530-751-0599
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ROBERT RIPLEY
Credential	:
Telephone Number	:	530-751-0599

Provider Enumeration Date	:	04/04/2014
Last Update Date	:	04/04/2014

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