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General NPI Number Information
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NPI Number | 1407743420
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Entity Type | Organization
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Legal Business Name | RIVERSIDE DENTISTRY PLLC
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Dates
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Enumeration Date | 06/23/2025
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Last Update Date | 06/23/2025
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Provider Practice Location Address
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Address Line | 192 ROCKINGHAM ST
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City | BELLOWS FALLS
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State | VT
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Zip | 05101-1349
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Country | US
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Telephone | 516-477-7172
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Fax |
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Provider Business Mailing Address
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Address Line | 1195 NORTH AVE APT 201
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City | BURLINGTON
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State | VT
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Zip | 05408-2813
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Country | US
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Telephone | 516-477-7172
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. AVRAHAM KATZ KATZ
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Credential |
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Telephone | 516-477-7172
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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