Organization
COLUMBIA RIVER DENTAL, P.C.
Active
Other names
Pine Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
GAIL DARDEN (DIRECTOR OF PAYOR RELATIONS)
(770) 916-8143
Entity
Organization
Contact information
Practice address
1531 MARYLAND AVE NE, WASHINGTON, DC 20002-7604
(770) 916-5028
Mailing address
210 INTERSTATE NORTH PKWY SE STE 300, ATLANTA, GA 30339-2233
(770) 916-8143
(770) 858-0657
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
Other
Enumeration date
02/08/2008
Last updated
09/02/2025
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