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Individual

DR. MIGUEL A RIVERA DIAZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
URB. BARALT, AVE. PRINCIPAL I - 8, FAJARDO, PR 00738
(787) 863-1865
Mailing address
HC 66, BOX 10335, FAJARDO, PR 00073
(787) 863-1865

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D1784
PR

Other

Enumeration date
12/08/2006
Last updated
07/08/2007
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