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General NPI Number Information
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NPI Number | 1932574050
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Entity Type | Organization
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Legal Business Name | YVETTE RIVERA DMD INC
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Dates
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Enumeration Date | 12/02/2015
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Last Update Date | 12/02/2015
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Provider Practice Location Address
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Address Line | 1042 N MOUNTAIN AVE SUITE A-2
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City | UPLAND
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State | CA
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Zip | 91786-3695
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Country | US
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Telephone | 909-931-0222
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Fax |
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Provider Business Mailing Address
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Address Line | 11186 TERRA VISTA PKWY #116
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-7423
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. YVETTE RIVERA
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Credential | D.M.D.
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Telephone | 562-774-6621
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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 | 53455
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License Number State | CA
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