Rivergate Village Dental

NPI #1336459791 in Madison, Tennessee

Provider Information

NPI Number: 1336459791
Entity Type: Organization
Organization Name: Rivergate Village Dental
Primary Specialty: Dentist
Enumeration Date: Oct 19, 2010
Last Updated: Oct 19, 2010

Practice Location

Address: 1570 GALLATIN PIKE N
City: Madison
State: Tennessee
ZIP Code: 37115-2124
Phone: (615) 865-6000

Authorized Official

Name: MS. SHAWN FOSTER
Title: PRACTICE ADMIN/REGIONAL DIRECTOR OP
Phone: (615) 498-4323

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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