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General NPI Number Information
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NPI Number | 1457847576
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Entity Type | Individual
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Provider Name | MARLYAN RIVERA HERNANDEZ DMD
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Gender | Female
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Dates
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Enumeration Date | 07/02/2018
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Last Update Date | 01/28/2021
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Provider Practice Location Address
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Address Line | CARR 1 KM 55.2 BO. MONTELLANO PLAZA CAYEY OFIC 201
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City | CAYEY
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State | PR
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Zip | 00736
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Country | US
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Telephone | 787-535-4631
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 334
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City | BARRANQUITAS
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State | PR
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Zip | 00794-0334
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Country | US
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Telephone | 787-955-6090
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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 | 3297
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 3297
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License Number State | PR
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