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Organization
RIVERSIDE DENTAL LLC
Active
Organization
RIVERSIDE DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID R STEVENS DDS (MANAGER)
(435) 673-3363
Entity
Organization
Contact information
Practice address
368 E RIVERSIDE DR, BLDG #2, ST GEORGE, UT 84790-6896
(435) 673-3363
Mailing address
368 E RIVERSIDE DR, BLDG #2, ST GEORGE, UT 84790-6896
(435) 673-3363
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
5929127-9923
UT
Other
Enumeration date
01/08/2009
Last updated
01/08/2009
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