Ryder, Jon Scott

Ryder, Jon Scott is an sole proprietor health care provider with primary practice located at 3435 Spring St , Davenport IA 52807-2142. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Ryder, Jon Scott can be contacted via phone (563) 355-6492.

Contact Information

Primary practice address
3435 Spring St Davenport IA 52807-2142
Phone: (563) 355-6492
Fax: (563) 355-2589
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 07837 Iowa

Profile Details

NPI number 1760522056
LBN Legal business name Ryder, Jon Scott
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 7th, 2007
Last updated Jul 8th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760522056 NPPES
Iowa Other 59851 BLUECROSS BLUE SHIELD
Iowa MEDICAID 0169813 BLUECROSS BLUE SHIELD

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