Organization
RIO GRANDE DENTAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL H RIVERA D.D.S. (GENERAL MANAGER & PARTNER)
(505) 758-0531
Entity
Organization
Contact information
Practice address
107 PLAZA GARCIA, #E-10, TAOS, NM 87571-6256
(505) 758-0531
Mailing address
107 PLAZA GARCIA, #E-10, TAOS, NM 87571-6256
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1670
NM
Other
Enumeration date
04/02/2007
Last updated
08/22/2020
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