Provider Demographics
NPI:1073137741
Name:OASIS DENTAL RIDGEFIELD
Entity Type:Organization
Organization Name:OASIS DENTAL RIDGEFIELD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:C
Authorized Official - Last Name:ALDRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:360-727-0335
Mailing Address - Street 1:11 S. 47TH AVE. SUITE 101
Mailing Address - Street 2:
Mailing Address - City:RIDGEFILED
Mailing Address - State:WA
Mailing Address - Zip Code:98642
Mailing Address - Country:US
Mailing Address - Phone:360-727-0355
Mailing Address - Fax:
Practice Address - Street 1:11 S. 47TH AVE. SUITE 101
Practice Address - Street 2:
Practice Address - City:RIDGEFILED
Practice Address - State:WA
Practice Address - Zip Code:98642
Practice Address - Country:US
Practice Address - Phone:360-727-0355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-29
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental