| Riverbend Pediatric Dentistry, Llc | |
|
705 Kansas St Bethalto IL 62010-1796 | |
| (618) 596-3725 | |
| Not Available |
| Full Name | Riverbend Pediatric Dentistry, Llc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 705 Kansas St, Bethalto, Illinois |
| Authorized Official Name and Position | Adam Miles Snyder (MANAGING MEMBER) |
| Authorized Official Contact | 6185819201 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Riverbend Pediatric Dentistry, Llc 705 Kansas St Bethalto IL 62010-1796 Ph: (618) 596-3725 | Riverbend Pediatric Dentistry, Llc 705 Kansas St Bethalto IL 62010-1796 Ph: (618) 596-3725 |
| NPI Number | 1770988594 |
|---|---|
| Provider Enumeration Date | 10/23/2014 |
| Last Update Date | 10/23/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770988594 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 021002548 (Illinois) | Primary |