Provider Demographics
NPI:1760900120
Name:CYNTHIA A RIDER DMD PLLC
Entity Type:Organization
Organization Name:CYNTHIA A RIDER DMD PLLC
Other - Org Name:RIDER ORAL SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:RIDER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:517-783-3130
Mailing Address - Street 1:2545 SPRING ARBOR RD STE 202
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49203-3791
Mailing Address - Country:US
Mailing Address - Phone:517-783-3130
Mailing Address - Fax:517-783-3140
Practice Address - Street 1:2545 SPRING ARBOR ROAD
Practice Address - Street 2:SUITE 202
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49203
Practice Address - Country:US
Practice Address - Phone:517-783-3130
Practice Address - Fax:517-783-3140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial SurgeryGroup - Multi-Specialty