Organization
RIVER VALLEY DENTAL GROUP PLLC
Active
Other names
River Valley Smile Center
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES G LIGGETT JR. DDS (PARTNER/OWNER)
(479) 646-0706
Entity
Organization
Contact information
Practice address
8309 PHOENIX AVENUE, FORT SMITH, AR 72903
(479) 646-0706
(479) 646-0502
Mailing address
8309 PHOENIX AVENUE, FORT SMITH, AR 72903
(479) 646-0706
(479) 646-0502
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
152884608
—
AR
05
—
159196608
—
AR
05
—
20032200A
—
OK
Enumeration date
07/05/2012
Last updated
03/02/2021
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