Healthcare Provider Details

I. General information

NPI: 1992981252
Provider Name (Legal Business Name): FRANCISCO J RIVERA DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2008
Last Update Date: 01/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVE AMERICAS 678-B
JUAREZ CHIHUAHUA
32310
MX

IV. Provider business mailing address

1120 WILL RAND DR
EL PASO TX
79912-7620
US

V. Phone/Fax

Practice location:
  • Phone: 656-616-2672
  • Fax:
Mailing address:
  • Phone: 915-449-8589
  • Fax: 915-833-8796

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number794883
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: