Provider Demographics
NPI:1174717037
Name:RIVERFRONT DENTAL CARE, P. A.
Entity type:Organization
Organization Name:RIVERFRONT DENTAL CARE, P. A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CORP. SEC./ OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGUERITE
Authorized Official - Middle Name:E
Authorized Official - Last Name:STEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-349-1295
Mailing Address - Street 1:117 E WATER ST
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-7517
Mailing Address - Country:US
Mailing Address - Phone:732-349-1295
Mailing Address - Fax:732-349-4053
Practice Address - Street 1:117 E WATER ST
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-7517
Practice Address - Country:US
Practice Address - Phone:732-349-1295
Practice Address - Fax:732-349-4053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-04
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty