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Individual

DR. MARIANO DE LA RIVA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
7450 SW 57TH AVE, #A, SOUTH MIAMI, FL 33143-5302
(650) 380-8872
Mailing address
19380 COLLINS AVE, APT. 1720, SUNNY ISLES BEACH, FL 33160-2239
(650) 380-8872

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
10368
CO
122300000X
Dentist
Primary
DN19967
FL

Other

Enumeration date
01/28/2011
Last updated
09/18/2012
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