Organization
MY RIVERTOWN DENTIST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY LEE (OWNER)
(812) 273-2388
Entity
Organization
Contact information
Practice address
2513 MICHIGAN RD, MADISON, IN 47250-2422
(812) 273-2388
Mailing address
2513 MICHIGAN RD, MADISON, IN 47250-2422
(812) 273-2388
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
05/27/2020
Last updated
07/08/2020
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