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General NPI Number Information
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NPI Number | 1184159873
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Entity Type | Organization
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Legal Business Name | STEVEN GAGLIO RIVAS DDS PLLC
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Dates
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Enumeration Date | 05/01/2017
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Last Update Date | 05/01/2017
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Provider Practice Location Address
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Address Line | 222 E RICE ST
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City | FALFURRIAS
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State | TX
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Zip | 78355-3622
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Country | US
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Telephone | 707-815-6330
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Fax |
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Provider Business Mailing Address
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Address Line | 222 E RICE ST
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City | FALFURRIAS
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State | TX
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Zip | 78355-3622
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Country | US
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Telephone | 707-815-6330
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. STEVEN GAGLIO RIVAS
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Credential | DDS
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Telephone | 707-815-6329
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 25196
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License Number State | TX
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