Organization
RIVERSIDE DENTAL MANAGEMENT, INC
Active
Other names
Denture Service
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN VILLANUEVA (PRACTICE MANAGER)
(630) 324-6749
Entity
Organization
Contact information
Practice address
7716 W. 26TH ST., NORTH RIVERSIDE, IL 60546-1509
(708) 447-2266
(708) 447-2486
Mailing address
7716 W. 26TH ST., NORTH RIVERSIDE, IL 60546-1509
(708) 447-2266
(708) 447-2486
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019022779
IL
1223G0001X
General Practice Dentistry
—
—
Other
Enumeration date
05/14/2007
Last updated
03/24/2010
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