| NPI | 1346744232 |
|---|---|
| Doing Business As | RIVER DENTAL FAYETTEVILLE |
| Entity Type | Organization |
| Authorized Contact | RENEE MCBAY Credentialing Specialist 918-998-0996 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2018-06-16 |