Provider Demographics
NPI:1043858780
Name:VALLEY RIVER FAMILY DENTAL PC
Entity Type:Organization
Organization Name:VALLEY RIVER FAMILY DENTAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:J
Authorized Official - Last Name:ELFORD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:541-485-4646
Mailing Address - Street 1:1400 EXECUTIVE PKWY STE 310
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-7102
Mailing Address - Country:US
Mailing Address - Phone:541-485-4646
Mailing Address - Fax:541-431-4542
Practice Address - Street 1:1400 EXECUTIVE PKWY STE 310
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-7102
Practice Address - Country:US
Practice Address - Phone:541-485-4646
Practice Address - Fax:541-431-4542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-12
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental