Organization
RIVER BEND DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARA DOUGHTY (ADMIN)
(812) 437-1015
Entity
Organization
Contact information
Practice address
1015 PROFESSIONAL BLVD, EVANSVILLE, IN 47714-8010
(812) 437-1015
Mailing address
1015 PROFESSIONAL BLVD, EVANSVILLE, IN 47714-8010
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12009288
IN
Other
Enumeration date
10/27/2011
Last updated
10/27/2011
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