| NPI | 1538638002 |
|---|---|
| Doing Business As | RIVERSIDE DENTAL AND BEAUTY SPA |
| Entity Type | Organization |
| Authorized Contact | BARBARA LEWIS-HEYWOOD Owner/Dentist 505-922-6000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2018-11-14 |
| Last Update Date | 2018-11-14 |