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General NPI Number Information
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NPI Number | 1538757760
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Entity Type | Organization
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Legal Business Name | RIVER TOWN DENTAL, LLC
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Dates
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Enumeration Date | 01/04/2021
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Last Update Date | 07/20/2023
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Provider Practice Location Address
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Address Line | 310 S. NELSON DRIVE SUITE C
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City | ARCADIA
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State | WI
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Zip | 54612-1897
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Country | US
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Telephone | 608-323-3888
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Fax | 608-323-3889
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Provider Business Mailing Address
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Address Line | 3143 STATE ROAD SUITE 100
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City | LA CROSSE
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State | WI
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Zip | 54601-6964
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Country | US
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Telephone | 608-788-0030
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Fax | 608-788-7881
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Authorized Official
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Title or Position | DIRECTOR OF ADMINISTRATIVE OPERATIO
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Name | JENNIFER E SCHIFFER
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Credential |
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Telephone | 608-788-0030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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