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Contact Information

RIVER VALLEY DENTAL GROUP PLLC
8309 PHOENIX AVENUE
FORT SMITH, AR72903
 Phone: 479-646-0706
 Fax: 479-646-0502
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for RIVER VALLEY DENTAL GROUP PLLC

NPI # 1376808394
LBN Legal business name RIVER VALLEY DENTAL GROUP PLLC
Authorized official CHARLES LIGGETT - (PARTNER/OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 07/05/2012
Last updated 03/02/2021 - About 5 years ago
Identifiers
AR Medicaid 152884608
AR Medicaid 159196608
OK Medicaid 20032200A
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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