Provider Demographics
NPI:1073673323
Name:RIES, JOSHUA ADAM (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:ADAM
Last Name:RIES
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2551 N CLARK ST STE 701
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-1705
Mailing Address - Country:US
Mailing Address - Phone:773-244-1933
Mailing Address - Fax:773-244-2933
Practice Address - Street 1:845 N MICHIGAN AVE STE 921E
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2213
Practice Address - Country:US
Practice Address - Phone:312-751-0026
Practice Address - Fax:312-751-0241
Is Sole Proprietor?:No
Enumeration Date:2006-12-09
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL021.0021961223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics