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Organization

RIVERSIDE DENTAL, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SHUTONG HARTSELL DMD (OWNER)
(703) 740-8978
Entity
Organization

Contact information

Practice address
3400 S CLARK ST STE 105, ARLINGTON, VA 22202-4050
(703) 740-8978
(571) 464-6588
Mailing address
6161 FOXCROFT RD, ALEXANDRIA, VA 22307-1103
(828) 719-5723

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Enumeration date
01/16/2022
Last updated
01/16/2022
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