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Organization

JOSEFA A RIVAS DDS PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOSEFA RIVAS (PRESIDENT)
(718) 482-8065
Entity
Organization

Contact information

Practice address
4527 47 STREET, WOODSIDE, NY 11377
(718) 482-8065
(718) 482-8066
Mailing address
4527 47TH ST, WOODSIDE, NY 11377-5225
(718) 482-8065
(718) 482-8066

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02408822
NY
Enumeration date
09/01/2016
Last updated
09/01/2016
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