Riverdale Dental

LBN: Smile Line Pc
Riverdale Dental is an health care organization with primary practice located at 1073 Riverdale St , West Springfield MA 01089-4614. The organization recently has only one registered license in Ambulatory Health Care Facilities / Dental, which is considered as the primary health care specialty. Smile Line Pc can be contacted via phone (413) 285-7114, or through Gaddam, Vijay via phone (419) 450-2211.

Contact Information

Primary practice address
1073 Riverdale St West Springfield MA 01089-4614
Phone: (413) 285-7114
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Gaddam, Vijay Doctor of Dental Medicine (DMD)
Phone: (419) 450-2211

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Dental 261QD0000X

Profile Details

NPI number 1457873895
LBN Legal business name Smile Line Pc
DBA Doing business as Riverdale Dental
Authorized official Gaddam, Vijay Doctor of Dental Medicine (DMD)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 7th, 2017
Last updated Aug 1st, 2017 - about 7 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457873895 NPPES
Massachusetts MEDICAID 9211482

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