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Organization

RILEY HANSEN DDS PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RILEY HANSEN DDS (OWNER)
(208) 810-0419
Entity
Organization

Contact information

Practice address
734 W LAMAR ALEXANDER PKWY, MARYVILLE, TN 37801-3900
(208) 810-0419
Mailing address
734 W LAMAR ALEXANDER PKWY, MARYVILLE, TN 37801-3900
(208) 810-0419

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Enumeration date
01/06/2025
Last updated
01/06/2025
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