Riverside Dental Management, INC

NPI #1356556146 in North Riverside, Illinois

Provider Information

NPI Number: 1356556146
Entity Type: Organization
Organization Name: Riverside Dental Management, INC
Primary Specialty: Dentist
Enumeration Date: May 14, 2007
Last Updated: Mar 24, 2010

Practice Location

Address: 7716 W. 26TH ST.
City: North Riverside
State: Illinois
ZIP Code: 60546-1509
Phone: (708) 447-2266

Authorized Official

Name: JONATHAN VILLANUEVA
Title: PRACTICE MANAGER
Phone: (630) 324-6749

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X
Dentist	122300000X	Primary

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