Provider Demographics
NPI:1376169854
Name:RIVERTOP DENTAL, LLC
Entity Type:Organization
Organization Name:RIVERTOP DENTAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HYUK
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:347-501-1110
Mailing Address - Street 1:383 KINDERKAMACK RD
Mailing Address - Street 2:
Mailing Address - City:ORADELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07649-2141
Mailing Address - Country:US
Mailing Address - Phone:201-267-6252
Mailing Address - Fax:201-377-5300
Practice Address - Street 1:383 KINDERKAMACK RD
Practice Address - Street 2:
Practice Address - City:ORADELL
Practice Address - State:NJ
Practice Address - Zip Code:07649-2141
Practice Address - Country:US
Practice Address - Phone:201-267-6252
Practice Address - Fax:201-377-5300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-22
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty