Provider Demographics
NPI:1578038931
Name:DENTURE MASTERS OF EUGENE
Entity Type:Organization
Organization Name:DENTURE MASTERS OF EUGENE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:W
Authorized Official - Last Name:RIDLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, PC
Authorized Official - Phone:541-206-4524
Mailing Address - Street 1:1925 BAILEY HILL RD STE A
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-1142
Mailing Address - Country:US
Mailing Address - Phone:541-345-0004
Mailing Address - Fax:
Practice Address - Street 1:1925 BAILEY HILL RD STE A
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405-1142
Practice Address - Country:US
Practice Address - Phone:541-345-0004
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-11
Last Update Date:2018-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies