MEDICARE: RIVERCREST FAMILY DENTAL, P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	8451	TX
2	122300000X	Dentist	21504	TX

General Provider Information

NPI Number	:	1437324589
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIVERCREST FAMILY DENTAL, P.A.

Provider Business Mailing Address
First Line	:	3029 INDEPENDENCE DR STE 100
Second Line	:
City	:	NEW BRAUNFELS
State	:	TX
Zip	:	78132-4474
Country	:	US
Telephone Number	:	830-625-7611
Fax Number	:	830-625-7691

Provider Business Practice Location Address
First Line	:	3029 INDEPENDENCE DR STE 100
Second Line	:
City	:	NEW BRAUNFELS
State	:	TX
Zip	:	78132-4474
Country	:	US
Telephone Number	:	830-625-7611
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JUSTIN SCOTT BARBER
Credential	:
Telephone Number	:	830-625-7611

Provider Enumeration Date	:	04/29/2008
Last Update Date	:	08/17/2021

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Directions to “RIVERCREST FAMILY DENTAL, P.A. ” Practice Location

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