Riverbend Pediatric Dentistry, Llc | |
705 Kansas St Bethalto IL 62010-1796 | |
(618) 596-3725 | |
Not Available |
Full Name | Riverbend Pediatric Dentistry, Llc |
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Speciality | Dentist - Pediatric Dentistry |
Location | 705 Kansas St, Bethalto, Illinois |
Authorized Official Name and Position | Adam Miles Snyder (MANAGING MEMBER) |
Authorized Official Contact | 6185819201 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Riverbend Pediatric Dentistry, Llc 705 Kansas St Bethalto IL 62010-1796 Ph: (618) 596-3725 | Riverbend Pediatric Dentistry, Llc 705 Kansas St Bethalto IL 62010-1796 Ph: (618) 596-3725 |
NPI Number | 1770988594 |
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Provider Enumeration Date | 10/23/2014 |
Last Update Date | 10/23/2014 |
Identifier | Type | State | Issuer |
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1770988594 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223P0221X | Dentist - Pediatric Dentistry | 021002548 (Illinois) | Primary |