Individual
LANCE GABRIEL RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2171 N HIGHWAY 77, WAXAHACHIE, TX 75165-6215
(469) 589-5303
Mailing address
2750 N HASKELL AVE APT 1314, DALLAS, TX 75204-0421
(214) 293-0728
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
41818
TX
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/02/2023
Last updated
07/24/2025
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