Provider Demographics
NPI:1013344985
Name:ARMORY DENTAL
Entity Type:Organization
Organization Name:ARMORY DENTAL
Other - Org Name:RIPLEY DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:E
Authorized Official - Last Name:RIPLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:651-345-3335
Mailing Address - Street 1:113 W CENTER ST
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:MN
Mailing Address - Zip Code:55041-1635
Mailing Address - Country:US
Mailing Address - Phone:651-345-3335
Mailing Address - Fax:651-345-2897
Practice Address - Street 1:217 PLUM ST STE 240
Practice Address - Street 2:
Practice Address - City:RED WING
Practice Address - State:MN
Practice Address - Zip Code:55066-2340
Practice Address - Country:US
Practice Address - Phone:651-388-8817
Practice Address - Fax:651-388-8819
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARMORY DENTAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-10-08
Last Update Date:2013-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND11814122300000X
MND11816122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty