Provider Demographics
NPI:1730629627
Name:RIVERWALK SMILE DENTISTRY, LLC
Entity type:Organization
Organization Name:RIVERWALK SMILE DENTISTRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANJALI
Authorized Official - Middle Name:
Authorized Official - Last Name:SETH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:803-639-7676
Mailing Address - Street 1:998 RIVERWALK PKWY
Mailing Address - Street 2:SUITE 203
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-0116
Mailing Address - Country:US
Mailing Address - Phone:803-639-7676
Mailing Address - Fax:803-639-7677
Practice Address - Street 1:998 RIVERWALK PKWY
Practice Address - Street 2:SUITE 203
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-0116
Practice Address - Country:US
Practice Address - Phone:803-639-7676
Practice Address - Fax:803-639-7677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-27
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty