# RIVERSIDE DENTAL P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245419308
- **Authorized official:** MISS ELIZABETH LA MADRID RAMIREZ (OFFICE ADMINISTRATOR)
- **Authorized official phone:** (520) 299-4470

## Contact information

- **Practice address:** 1640 E RIVER RD STE 112, TUCSON, AZ 85718-7645
- **Practice address phone:** (520) 299-4470
- **Practice address fax:** (520) 299-4475
- **Mailing address:** 1640 E RIVER RD STE 112, TUCSON, AZ 85718-7645
- **Mailing address phone:** (520) 299-4470
- **Mailing address fax:** (520) 299-4475

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | D5225 | AZ | Yes |

## Other

- **Enumeration date:** 10/25/2007
- **Last updated:** 10/25/2007