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General NPI Number Information
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NPI Number | 1245444926
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Entity Type | Individual
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Provider Name | RAFAEL J RIVERA DDM
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Gender | Male
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | D16 AVE ROBERTO CLEMENTE
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City | CAROLINA
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State | PR
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Zip | 00985-5457
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Country | US
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Telephone | 787-757-0290
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3456
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City | CAROLINA
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State | PR
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Zip | 00984-3456
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Country | US
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Telephone | 939-642-7465
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Fax | 787-762-6274
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 814
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License Number State | PR
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