| Riverside Dental Clinic | |
|
225 W Waco Dr Waco TX 76707-3836 | |
| (254) 750-5487 | |
| Not Available |
| Full Name | Riverside Dental Clinic |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 225 W Waco Dr, Waco, Texas |
| Authorized Official Name and Position | Allen E Patterson (CFO) |
| Authorized Official Contact | 2547508202 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Riverside Dental Clinic 1600 Providence Dr Waco TX 76707-2261 Ph: (254) 750-8200 | Riverside Dental Clinic 225 W Waco Dr Waco TX 76707-3836 Ph: (254) 750-5487 |
| NPI Number | 1528389434 |
|---|---|
| Provider Enumeration Date | 06/15/2010 |
| Last Update Date | 06/15/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528389434 | NPI | - | NPPES |
| 092957202 | Medicaid | TX | |
| FQ0000676 | Other | TX | MEDICAID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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