Provider Demographics
NPI:1427175884
Name:RYDER, ART W (DMD)
Entity type:Individual
Prefix:DR
First Name:ART
Middle Name:W
Last Name:RYDER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:813 DOUGLAS AVE
Mailing Address - Street 2:SUITE 5
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-2008
Mailing Address - Country:US
Mailing Address - Phone:407-740-6500
Mailing Address - Fax:407-260-9654
Practice Address - Street 1:813 DOUGLAS AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-2008
Practice Address - Country:US
Practice Address - Phone:407-740-6500
Practice Address - Fax:407-260-9654
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL80671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice