| River Park Dental Center | |
|
17320 W Grand Pkwy S Ste B Sugar Land TX 77479-2667 | |
| (832) 595-2505 | |
| (832) 595-2290 |
| Full Name | River Park Dental Center |
|---|---|
| Speciality | Dentist |
| Location | 17320 W Grand Pkwy S Ste B, Sugar Land, Texas |
| Authorized Official Name and Position | Liyen Lin Keen (PRESIDENT) |
| Authorized Official Contact | 8325952505 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| River Park Dental Center 17320 W Grand Pkwy S Ste B Sugar Land TX 77479-2667 Ph: (832) 595-2505 | River Park Dental Center 17320 W Grand Pkwy S Ste B Sugar Land TX 77479-2667 Ph: (832) 595-2505 |
| NPI Number | 1053314476 |
|---|---|
| Provider Enumeration Date | 05/31/2005 |
| Last Update Date | 12/25/2022 |
| Medicare PECOS PAC ID | 2466826672 |
|---|---|
| Medicare Enrollment ID | O20230329001687 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053314476 | NPI | - | NPPES |
| 00001727583 | Other | TX | UNITED CONCORDIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 20585 (Texas) | Primary |
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