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General NPI Number Information
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NPI Number | 1821982331
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Entity Type | Individual
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Provider Name | ANGELIZ RIVERA-CONCEPCION DDS
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Gender | Female
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Dates
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Enumeration Date | 06/07/2025
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Last Update Date | 06/07/2025
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Provider Practice Location Address
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Address Line | 103 SUPERIOR DR
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City | SPRING LAKE
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State | NC
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Zip | 28390-3193
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Country | US
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Telephone | 910-497-3200
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Fax |
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Provider Business Mailing Address
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Address Line | 6459 BROOKSHIRE ST
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City | FAYETTEVILLE
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State | NC
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Zip | 28314-6512
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Country | US
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Telephone | 919-903-1789
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 14229
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License Number State | NC
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