MEDICARE: DR. LUIS R RIVERA-NAVARRO DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	1898	PR

General Provider Information

NPI Number	:	1346249893
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LUIS R RIVERA-NAVARRO DMD

Provider Business Mailing Address
First Line	:	PO BOX 56
Second Line	:
City	:	CANOVANAS
State	:	PR
Zip	:	00729-0056
Country	:	US
Telephone Number	:	787-463-9074
Fax Number	:	787-957-7836

Provider Business Practice Location Address
First Line	:	CALLE 2 G-42
Second Line	:	VILLAS DORADAS
City	:	CANOVANAS
State	:	PR
Zip	:	00729
Country	:	US
Telephone Number	:	787-463-9074
Fax Number	:	787-957-7836

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	03/21/2013

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