Organization
RIVER VALLEY PRIMARY CARE SERVICES
Active
Other names
Lavaca Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
JEROME J WHITE (CEO)
(479) 431-2057
Entity
Organization
Contact information
Practice address
603 S DIVISION ST, LAVACA, AR 72941-4129
(479) 279-7683
(479) 279-7684
Mailing address
PO BOX 130, RATCLIFF, AR 72951-0130
(479) 431-2057
(479) 431-2058
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
05/18/2021
Last updated
05/18/2021
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