| Riverwalk Dental Spa | |
|
11695 Slate Ave Ste 200 Riverside CA 92505-5197 | |
| (951) 353-0050 | |
| (951) 353-0060 |
| Full Name | Riverwalk Dental Spa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 11695 Slate Ave Ste 200, Riverside, California |
| Authorized Official Name and Position | Truc Trung Mai (DENTIST) |
| Authorized Official Contact | 9513530050 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Riverwalk Dental Spa 11695 Slate Ave Ste 200 Riverside CA 92505-5197 Ph: (951) 353-0050 | Riverwalk Dental Spa 11695 Slate Ave Ste 200 Riverside CA 92505-5197 Ph: (951) 353-0050 |
| NPI Number | 1972052322 |
|---|---|
| Provider Enumeration Date | 09/27/2016 |
| Last Update Date | 09/27/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972052322 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 44934 (California) | Primary |
| 1223G0001X | Dentist - General Practice | 44933 (California) | Secondary |
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