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Individual

DR. TEODORO LOPEZ RIVERA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.M.D., MSCD.

Contact information

Practice address
EDIFICIO CLAUSELLS 129 CALLE VILLA, SUITE 24, PONCE, PR 00730
(787) 844-1880
(787) 844-5885
Mailing address
PO BOX 330707, PONCE, PR 00733-0707
(787) 844-1880
(787) 844-5885

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
728
PR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
040471
CRUZ AZUL
PR
01
237025
UTI
PR
01
40719
SEGUROS SERVICIOS SALUD
PR
01
4722
INTERNATIONAL MEDICAL CAR
PR
01
7310173
HUMANA
PR
Enumeration date
06/27/2005
Last updated
06/27/2016
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