Provider Demographics
NPI:1659175602
Name:RIVER VALLEY DENTISTRY SIGNAL
Entity type:Organization
Organization Name:RIVER VALLEY DENTISTRY SIGNAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDRIA
Authorized Official - Middle Name:PAGE
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-886-1160
Mailing Address - Street 1:809 RIDGEWAY AVE
Mailing Address - Street 2:
Mailing Address - City:SIGNAL MOUNTAIN
Mailing Address - State:TN
Mailing Address - Zip Code:37377-3003
Mailing Address - Country:US
Mailing Address - Phone:423-886-1160
Mailing Address - Fax:423-886-6608
Practice Address - Street 1:809 RIDGEWAY AVE
Practice Address - Street 2:
Practice Address - City:SIGNAL MOUNTAIN
Practice Address - State:TN
Practice Address - Zip Code:37377-3003
Practice Address - Country:US
Practice Address - Phone:423-886-1160
Practice Address - Fax:423-886-6608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental