# RIVER BEND DENTAL GROUP

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

## Provider details

- **NPI number:** 1881970424
- **Authorized official:** TARA DOUGHTY (ADMIN)
- **Authorized official phone:** (812) 437-1015

## Contact information

- **Practice address:** 1015 PROFESSIONAL BLVD, EVANSVILLE, IN 47714-8010
- **Practice address phone:** (812) 437-1015
- **Mailing address:** 1015 PROFESSIONAL BLVD, EVANSVILLE, IN 47714-8010

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 12009288 | IN | Yes |

## Other

- **Enumeration date:** 10/27/2011
- **Last updated:** 10/27/2011