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Organization
RIVER VALLEY FAMILY DENTISTRY INC
Active
Organization
RIVER VALLEY FAMILY DENTISTRY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH M TAYLOR (OFFICE MANAGER)
(334) 297-2990
Entity
Organization
Contact information
Practice address
1007 BROAD ST, PHENIX CITY, AL 36867-5919
(334) 297-2990
(334) 297-2955
Mailing address
1007 BROAD ST, PHENIX CITY, AL 36867-5919
(334) 297-2990
(334) 297-2955
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6304
GENERAL DENTISTRY
AL
Enumeration date
07/13/2020
Last updated
07/13/2020
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