| Hamilton Riverside Dentistry Llc | |
|
112 N. Second St Hamilton OH 45011 | |
| (513) 868-0200 | |
| Not Available |
| Full Name | Hamilton Riverside Dentistry Llc |
|---|---|
| Speciality | Dentist |
| Location | 112 N. Second St, Hamilton, Ohio |
| Authorized Official Name and Position | David T Tankovich (OPERATIONS DIRECTOR) |
| Authorized Official Contact | 5138680200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hamilton Riverside Dentistry Llc 112 N 2nd St Hamilton OH 45011-2702 Ph: (513) 868-0200 | Hamilton Riverside Dentistry Llc 112 N. Second St Hamilton OH 45011 Ph: (513) 868-0200 |
| NPI Number | 1356758015 |
|---|---|
| Provider Enumeration Date | 07/15/2014 |
| Last Update Date | 12/08/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356758015 | NPI | - | NPPES |
| 0106920 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 30019324 (Ohio) | Primary |
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