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Organization
RIVERS FAMILY DENTISTRY, PLLC
Active
Organization
RIVERS FAMILY DENTISTRY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTINA RIVERS (PRESIDENT)
(979) 779-6146
Entity
Organization
Contact information
Practice address
110 E VILLA MARIA RD, SUITE A, BRYAN, TX 77801-3147
(979) 779-6146
Mailing address
709C VASSAR CT, COLLEGE STATION, TX 77840-2142
(817) 925-0458
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
23933
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1740411016
—
TX
Enumeration date
08/08/2014
Last updated
08/08/2014
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