Organization
THREE RIVERS DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LOGAN KEVIN REILLY D.M.D. (SOLE MEMBER)
(920) 284-8640
Entity
Organization
Contact information
Practice address
655 PORTSMOUTH AVE, SUITE 9, GREENLAND, NH 03840-2246
(920) 284-8640
Mailing address
655 PORTSMOUTH AVE, SUITE 9, GREENLAND, NH 03840-2246
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
03795
NH
Other
Enumeration date
12/13/2012
Last updated
12/13/2012
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