Provider Demographics
NPI:1871698548
Name:RIDENOUR, LLOYD CHARLES III (DDS)
Entity type:Individual
Prefix:DR
First Name:LLOYD
Middle Name:CHARLES
Last Name:RIDENOUR
Suffix:III
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 NORTH ELM
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201
Mailing Address - Country:US
Mailing Address - Phone:940-382-6441
Mailing Address - Fax:940-383-8431
Practice Address - Street 1:1401 NORTH ELM
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201
Practice Address - Country:US
Practice Address - Phone:940-382-6441
Practice Address - Fax:940-383-8431
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX150831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice