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Organization
RIVER RUN DENTAL OF LIBBIE MILL, PLLC
Active
Organization
RIVER RUN DENTAL OF LIBBIE MILL, PLLC
Active
Other names
River Run Dental
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD HENDRICKS (CREDENTIALING)
(612) 859-0444
Entity
Organization
Contact information
Practice address
5001 LIBBIE MILL EAST BLVD STE 125, RICHMOND, VA 23230-2152
(804) 390-7133
Mailing address
5001 LIBBIE MILL EAST BLVD STE 125, RICHMOND, VA 23230-2152
(804) 390-7133
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0300X
Periodontics
—
NULL
1223P0300X
Periodontics
—
—
Other
Enumeration date
11/04/2022
Last updated
11/04/2022
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