# RIVER CITY DENTAL, PLLC

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

## Provider details

- **NPI number:** 1689968968
- **Authorized official:** DR. FRANKLIN T WORTHAM (MEMBER)
- **Authorized official phone:** (907) 252-8907

## Contact information

- **Practice address:** 7723 W RIVERSIDE DR, BOISE, ID 83714-6182
- **Practice address phone:** (208) 853-8811
- **Practice address fax:** (208) 853-2495
- **Mailing address:** 7723 W RIVERSIDE DR, BOISE, ID 83714-6182
- **Mailing address phone:** (208) 853-8811
- **Mailing address fax:** (208) 853-2495

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | D3475 | ID | Yes |

## Other

- **Enumeration date:** 06/04/2011
- **Last updated:** 06/04/2011