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General NPI Number Information
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NPI Number | 1922063833
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Entity Type | Individual
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Provider Name | MERCEDES I RIVERA DMD
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Gender | Female
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Dates
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Enumeration Date | 04/20/2006
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | PO BOX 1427
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City | CIALES
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State | PR
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Zip | 00638-1427
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Country | US
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Telephone | 787-871-0601
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Fax |
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Provider Business Mailing Address
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Address Line | 1 AVE SAN AGUSTIN URB. SAN AGUSTIN
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City | VEGA BAJA
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State | PR
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Zip | 00693-0000
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Country | US
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Telephone | 787-384-2316
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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 | 1715
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License Number State | PR
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