Individual
JADIE WANDA RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
5800 3RD AVE, BROOKLYN, NY 11220-3702
(718) 630-6180
(718) 630-7437
Mailing address
150 55TH ST, BROOKLYN, NY 11220-2559
(718) 630-6875
(718) 630-6279
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
51025921
NY
Other
Enumeration date
12/04/2009
Last updated
12/04/2009
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