Individual
LISA RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
576 JEFFERSON AVE, FORT EUSTIS, VA 23604-1373
(757) 314-7500
Mailing address
109 LILBURNE WAY, YORKTOWN, VA 23693-4452
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
0402203647
VA
Other
Enumeration date
11/12/2015
Last updated
03/20/2025
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