Provider Demographics
NPI:1629098462
Name:SALINA RIVERSIDE DENTAL CARE, P. A.
Entity Type:Organization
Organization Name:SALINA RIVERSIDE DENTAL CARE, P. A.
Other - Org Name:JEFF, KOKSAL, D.D.S., P.A.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:T
Authorized Official - Last Name:KOKSAL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:785-827-4401
Mailing Address - Street 1:950 ELMHURST BLVD
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-7402
Mailing Address - Country:US
Mailing Address - Phone:785-827-4401
Mailing Address - Fax:785-827-1560
Practice Address - Street 1:950 ELMHURST BLVD
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-7402
Practice Address - Country:US
Practice Address - Phone:785-827-4401
Practice Address - Fax:785-827-1560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty