Organization
EAST RIVER RP HOLDINGS LLC
Active
Other names
Havens-Jenkins Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN ANDREW HAVENS DDS (GENERAL PARTNER)
(716) 830-2314
Entity
Organization
Contact information
Practice address
1348 E RIVER RD, GRAND ISLAND, NY 14072-2743
(716) 773-7682
Mailing address
1348 E RIVER RD, GRAND ISLAND, NY 14072-2743
(716) 773-7682
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1528220860
INDIVIDUAL NPI
—
01
—
1568519874
INDIVIDUAL NPI
—
01
—
1710035043
INDIVIDUAL NPI
—
Enumeration date
12/03/2020
Last updated
12/03/2020
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