Provider Demographics
NPI:1194945055
Name:ALL SMILES AT RIVERFRONT DENTAL
Entity type:Organization
Organization Name:ALL SMILES AT RIVERFRONT DENTAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:MARCUS
Authorized Official - Last Name:SCHUMER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:989-790-6700
Mailing Address - Street 1:3066 DAVENPORT AVE
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48602-3651
Mailing Address - Country:US
Mailing Address - Phone:989-790-6700
Mailing Address - Fax:989-790-6724
Practice Address - Street 1:3066 DAVENPORT AVE
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602-3651
Practice Address - Country:US
Practice Address - Phone:989-790-6700
Practice Address - Fax:989-790-6724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIBS4703864OtherDEA#