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General NPI Number Information
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NPI Number | 1639993348
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Entity Type | Organization
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Legal Business Name | G R RIOS DENTAL CARE PLLC
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Dates
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Enumeration Date | 11/09/2024
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Last Update Date | 11/09/2024
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Provider Practice Location Address
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Address Line | 2709 FOREST RD
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City | SPRING HILL
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State | FL
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Zip | 34606-3377
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Country | US
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Telephone | 352-403-0676
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Fax |
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Provider Business Mailing Address
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Address Line | 2709 FOREST RD
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City | SPRING HILL
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State | FL
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Zip | 34606-3377
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Country | US
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Telephone | 352-403-0676
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Fax |
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Authorized Official
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Title or Position | DENTAL PRACTICE OWNER
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Name | GRETEL RUBIO RIOS
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Credential | DMD
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Telephone | 352-403-0676
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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 |
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License Number State |
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