Individual
EDGARDO RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
4 CALLE VENDIG, MANATI, PR 00674-5327
(787) 854-6759
Mailing address
4 CALLE VENDIG, MANATI, PR 00674-5327
(787) 854-6759
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1660
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
41556
SSS PROVIDER ID
PR
Enumeration date
02/13/2006
Last updated
07/08/2007
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