Provider Demographics
NPI:1841691920
Name:DRV DENTAL CLINICS, LLC
Entity type:Organization
Organization Name:DRV DENTAL CLINICS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:RILEY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:713-339-3554
Mailing Address - Street 1:9540 RICHMOND AVE
Mailing Address - Street 2:SUITE -B
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-3849
Mailing Address - Country:US
Mailing Address - Phone:713-339-3554
Mailing Address - Fax:713-339-3564
Practice Address - Street 1:9540 RICHMOND AVE
Practice Address - Street 2:SUITE -B
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-3849
Practice Address - Country:US
Practice Address - Phone:713-339-3554
Practice Address - Fax:713-339-3564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-09
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX27853261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental