Organization
RIVERSIDE DENTAL P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ELIZABETH LA MADRID RAMIREZ (OFFICE ADMINISTRATOR)
(520) 299-4470
Entity
Organization
Contact information
Practice address
1640 E RIVER RD STE 112, TUCSON, AZ 85718-7645
(520) 299-4470
(520) 299-4475
Mailing address
1640 E RIVER RD STE 112, TUCSON, AZ 85718-7645
(520) 299-4470
(520) 299-4475
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D5225
AZ
Other
Enumeration date
10/25/2007
Last updated
10/25/2007
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