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Contact Information

RIVER WILLOW DENTAL CENTER LLC
2 WAINWRIGHT ST STE 210
WASHINGTON, MO63090
 Phone: 636-392-6797
 Fax: 636-392-6792
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
 

Dental

261QD0000X
Indicates primary specialty

NPI Profile & details for RIVER WILLOW DENTAL CENTER LLC

NPI # 1427857127
LBN Legal business name RIVER WILLOW DENTAL CENTER LLC
Authorized official MARTIN BRUNWORTH - (OWNER DENTIST)
Entity Organization
Organization subpart 1 No
Enumeration date 03/13/2025
Last updated 12/17/2025 - About 6 months ago
Identifiers
MO Medicaid 500154903
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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