| Riverside Dentistry, Llc | |
|
609 22nd St Moline IL 61265-1450 | |
| (309) 797-2001 | |
| (309) 764-8236 |
| Full Name | Riverside Dentistry, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 609 22nd St, Moline, Illinois |
| Authorized Official Name and Position | Ronald D Riggins (OWNER) |
| Authorized Official Contact | 3097972001 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Riverside Dentistry, Llc 609 22nd St Moline IL 61265-1450 Ph: (309) 797-2001 | Riverside Dentistry, Llc 609 22nd St Moline IL 61265-1450 Ph: (309) 797-2001 |
| NPI Number | 1427349216 |
|---|---|
| Provider Enumeration Date | 04/27/2011 |
| Last Update Date | 04/27/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427349216 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019017034 (Illinois) | Secondary |
| 1223G0001X | Dentist - General Practice | 019025287 (Illinois) | Primary |
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