Provider Demographics
NPI:1659599553
Name:RIVERHILL DENTAL ASSOC DDS SC
Entity Type:Organization
Organization Name:RIVERHILL DENTAL ASSOC DDS SC
Other - Org Name:RIVERHILL DENTAL ASSOC LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:N
Authorized Official - Last Name:SANDS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:715-258-3311
Mailing Address - Street 1:701 RIVERSIDE DRIVE
Mailing Address - Street 2:
Mailing Address - City:WAUPACA
Mailing Address - State:WI
Mailing Address - Zip Code:54981
Mailing Address - Country:US
Mailing Address - Phone:715-258-3311
Mailing Address - Fax:715-258-4104
Practice Address - Street 1:701 RIVERSIDE DRIVE
Practice Address - Street 2:
Practice Address - City:WAUPACA
Practice Address - State:WI
Practice Address - Zip Code:54981
Practice Address - Country:US
Practice Address - Phone:715-258-3311
Practice Address - Fax:715-258-4104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty