Organization
RIVERSIDE DENTAL STUDIO, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL DAVID MATTIACIO DDS (PRESIDENT)
(315) 885-5885
Entity
Organization
Contact information
Practice address
2 OSWEGO ST STE 200, BALDWINSVILLE, NY 13027-2550
(315) 638-2288
(315) 638-4132
Mailing address
2 OSWEGO ST STE 200, BALDWINSVILLE, NY 13027-2550
(315) 638-2288
(315) 638-4132
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
06/02/2025
Last updated
06/02/2025
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