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General NPI Number Information
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NPI Number | 1073996542
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Entity Type | Individual
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Provider Name | RACHEL FOSTER RIVARD D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 07/02/2015
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Last Update Date | 06/26/2019
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Provider Practice Location Address
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Address Line | 69 ALLEN ST STE 10
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City | RUTLAND
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State | VT
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Zip | 05701-4564
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Country | US
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Telephone | 802-774-5050
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Fax |
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Provider Business Mailing Address
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Address Line | 5217 16TH AVE S
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City | MINNEAPOLIS
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State | MN
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Zip | 55417-1813
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Country | US
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Telephone | 847-910-2314
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D13583
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License Number State | MN
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