Healthcare Provider Details

I. General information

NPI: 1114078094
Provider Name (Legal Business Name): RIVER VALLEY DENTAL CLINIC, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

132 WALNUT AVE STE 6
GRAND JUNCTION CO
81501-7483
US

IV. Provider business mailing address

132 WALNUT AVE STE 6
GRAND JUNCTION CO
81501-7483
US

V. Phone/Fax

Practice location:
  • Phone: 970-242-5151
  • Fax: 970-255-6664
Mailing address:
  • Phone: 970-242-5151
  • Fax: 970-255-6664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number8541
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number8541
License Number StateCO

VIII. Authorized Official

Name: DONALD MILONI
Title or Position: BUSINESS OWNER
Credential: DDS
Phone: 303-744-3007