| Riverdale Dental | |
|
1073 Riverdale St West Springfield MA 01089-4614 | |
| (413) 285-7114 | |
| Not Available |
| Full Name | Riverdale Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1073 Riverdale St, West Springfield, Massachusetts |
| Authorized Official Name and Position | Vijay Gaddam (OWNER) |
| Authorized Official Contact | 4194502211 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Riverdale Dental 20 Pinewood Dr Longmeadow MA 01106-1638 Ph: (419) 450-2211 | Riverdale Dental 1073 Riverdale St West Springfield MA 01089-4614 Ph: (413) 285-7114 |
| NPI Number | 1457873895 |
|---|---|
| Provider Enumeration Date | 07/07/2017 |
| Last Update Date | 08/01/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457873895 | NPI | - | NPPES |
| 9211482 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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