| NPI | 1407984958 |
|---|---|
| Doing Business As | RIVERSIDE DENTAL |
| Entity Type | Organization |
| Authorized Contact | MICHAEL D. SPENCER President 904-355-5531 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL 8985) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2008-06-23 |