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Organization

RIVERFAMILYDENTALPRESENTEDBYDR.MANALSUNNADDSLLC

Active
Other names
River Family Dental
Organization subpart
No

Provider details

NPI number
Authorized official
CATHRYN BUCKNER DENTAL ASSITANT (OFFICE MANAGER)
(216) 268-3060
Entity
Organization

Contact information

Practice address
4163 PEARL RD, 28651 TOUCHSTONE CIR, CLEVELAND, OH 44109-3332
(440) 454-4878
(216) 862-3585
Mailing address
4163 PEARL RD, 28651 TOUCHSTONE CIR, CLEVELAND, OH 44109-3332
(440) 454-4878
(216) 862-3585

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1223P0221X
Pediatric Dentistry

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0066021
OH
Enumeration date
02/08/2017
Last updated
02/08/2017
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