Organization
RIVERBEND PEDIATRIC DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ADAM MILES SNYDER DMD, MSD (MANAGING MEMBER)
(618) 581-9201
Entity
Organization
Contact information
Practice address
705 KANSAS ST, BETHALTO, IL 62010-1796
(618) 596-3725
Mailing address
705 KANSAS ST, BETHALTO, IL 62010-1796
(618) 596-3725
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
021002548
IL
Other
Enumeration date
10/23/2014
Last updated
10/23/2014
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