| East River Rp Holdings Llc | |
|
1348 E River Rd Grand Island NY 14072-2743 | |
| (716) 773-7682 | |
| Not Available |
| Full Name | East River Rp Holdings Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1348 E River Rd, Grand Island, New York |
| Authorized Official Name and Position | John Andrew Havens (GENERAL PARTNER) |
| Authorized Official Contact | 7168302314 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| East River Rp Holdings Llc 1348 E River Rd Grand Island NY 14072-2743 Ph: (716) 773-7682 | East River Rp Holdings Llc 1348 E River Rd Grand Island NY 14072-2743 Ph: (716) 773-7682 |
| NPI Number | 1457956781 |
|---|---|
| Provider Enumeration Date | 12/03/2020 |
| Last Update Date | 12/03/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457956781 | NPI | - | NPPES |
| 1568519874 | Other | INDIVIDUAL NPI | |
| 1710035043 | Other | INDIVIDUAL NPI | |
| 1528220860 | Other | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Hennigar & Hennigar Dmd, Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2025 Whitehaven Rd, Grand Island, NY 14072 Phone: 716-773-1990 Fax: 716-773-1990 |