Riverside Family Dental, LLC
NPI #1558846725 in Riverside, Rhode Island
Provider Information
- NPI Number
- 1558846725
- Entity Type
- Organization
- Organization Name
- Riverside Family Dental, LLC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Oct 3, 2018
- Last Updated
- Oct 3, 2018
Practice Location
- Address
- 1445 WAMPANOAG TRL UNIT 209
- City
- Riverside
- State
- Rhode Island
- ZIP Code
- 02915-1019
- Phone
- (401) 433-2400
Authorized Official
- Name
- MARDY COSTA
- Title
- ADMINISTRATOR
- Phone
- (508) 728-5019
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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