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Individual

MRS. MARIA GUADALUPE RIVERA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.M.D.

Contact information

Practice address
2016 W 16TH ST, SAFFORD, AZ 85546-4026
(928) 428-1500
Mailing address
808 N MISSION PKWY, CASA GRANDE, AZ 85194-8412
(520) 426-3639

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
D009003
AZ
1223G0001X
General Practice Dentistry
Primary
D009003
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
949413
AZ
Enumeration date
07/16/2014
Last updated
03/08/2016
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