Provider Demographics
NPI:1760877583
Name:RIVERVIEW DENTAL CARE LTD
Entity Type:Organization
Organization Name:RIVERVIEW DENTAL CARE LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JIGNA
Authorized Official - Middle Name:T
Authorized Official - Last Name:THAKKAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:847-530-9675
Mailing Address - Street 1:451 DUNHAM RD
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174-1431
Mailing Address - Country:US
Mailing Address - Phone:847-530-9675
Mailing Address - Fax:
Practice Address - Street 1:451 DUNHAM RD
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-1431
Practice Address - Country:US
Practice Address - Phone:847-530-9675
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-30
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019025372122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty