Organization
RIVER CITY DENTAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY C. TILTON DDS (PRESIDENT)
(740) 373-1826
Entity
Organization
Contact information
Practice address
124 3RD ST, MARIETTA, OH 45750-3108
(740) 373-1826
(740) 373-1825
Mailing address
124 3RD ST, MARIETTA, OH 45750-3108
(740) 373-1826
(740) 373-1825
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
16905
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16905
OHIO DENTAL LICENSE
OH
01
—
18750
OHIO DENTAL LICENSE
OH
Enumeration date
04/12/2007
Last updated
08/22/2020
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