Riederer, Mark S.
Riederer, Mark S. is an sole proprietor health care provider with primary practice located at 9309 Glacier Hwy B-105, Juneau AK 99801-9306. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Riederer, Mark S. can be contacted via phone (907) 789-3100.Contact Information
Primary practice address
9309 Glacier Hwy B-105
Juneau AK 99801-9306
Phone: (907) 789-3100
Fax: (907) 789-3119
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | AA651 | Alaska |
Profile Details
| NPI number | 1366465882 |
|---|---|
| LBN Legal business name | Riederer, Mark S. |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 25th, 2006 |
| Last updated | Jul 9th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1366465882 | NPPES |
| Alaska | MEDICAID | DD6510 |
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