Provider Demographics
NPI:1548540925
Name:RILEY DENTAL ASSOCIATES OF CENTRAL VIRGINIA
Entity type:Organization
Organization Name:RILEY DENTAL ASSOCIATES OF CENTRAL VIRGINIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNDI
Authorized Official - Middle Name:C
Authorized Official - Last Name:RILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-385-7707
Mailing Address - Street 1:3709 OLD FOREST RD
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24501-6902
Mailing Address - Country:US
Mailing Address - Phone:434-385-7707
Mailing Address - Fax:434-385-0738
Practice Address - Street 1:3709 OLD FOREST RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501-6902
Practice Address - Country:US
Practice Address - Phone:434-385-7707
Practice Address - Fax:434-385-0738
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-17
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401005655122300000X
VA0401413248122300000X
VA0401008244122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty