Provider Demographics
NPI:1366712036
Name:RIES, DAVID R (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:R
Last Name:RIES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1609 CHAPEL HILL RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-6368
Mailing Address - Country:US
Mailing Address - Phone:573-446-0700
Mailing Address - Fax:
Practice Address - Street 1:1609 CHAPEL HILL RD
Practice Address - Street 2:SUITE B
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-6368
Practice Address - Country:US
Practice Address - Phone:573-446-0700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-11
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20080155211223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics