RIVERSIDE DENTAL PC
Organization (NPI-2)
Active
Dentist
Provider Information
- NPI Number
1053321885- Provider Type
- Organization / Facility (NPI-2)
- Status
- Active
Contact & Location
- Address
- 1120 PARKWAY DR, BLACKFOOT, ID, 83221
- Phone
- (208) 785-0878
- Fax
- (208) 785-0878
Specialties & Taxonomies
Dentist
Primary License: ID #d3225