Organization
RIVERSIDE DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMANDA VESTERSO DDS (OWNER)
(701) 772-3544
Entity
Organization
Contact information
Practice address
1165 S COLUMBIA RD, STE. B, GRAND FORKS, ND 58201-4007
(701) 772-3544
(701) 772-3411
Mailing address
1165 S COLUMBIA RD, STE. B, GRAND FORKS, ND 58201-4007
(701) 772-3544
(701) 772-3411
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2037
ND
Other
Enumeration date
05/02/2017
Last updated
05/02/2017
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