| NPI | 1669819769 |
|---|---|
| Doing Business As | RIVERSIDE DENTAL |
| Entity Type | Organization |
| Authorized Contact | JENNIFER LYNN HOUGH CEO 360-834-3533 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WA 7268) |
| Enumeration Date | 2013-05-29 |
| Last Update Date | 2013-05-29 |