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Organization

JESSE RIVAS, DDS, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JESSE RIVAS D.D.S. (PRESIDENT/DENTIST)
(972) 254-4204
Entity
Organization

Contact information

Practice address
811 N MACARTHUR BLVD, IRVING, TX 75061-7325
(972) 254-4204
(972) 254-1183
Mailing address
811 N MACARTHUR BLVD, IRVING, TX 75061-7325
(972) 254-4204
(972) 254-1183

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
19348
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
007920405
TX
Enumeration date
03/02/2012
Last updated
03/02/2012
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