Organization
ROBERT W.RIVES, D.D.S., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT WAYNE RIVES D.D.S. (OWNER)
(601) 366-7396
Entity
Organization
Contact information
Practice address
1445 LELIA DR, JACKSON, MS 39216-4721
(601) 366-7396
(610) 366-7549
Mailing address
1445 LELIA DR, JACKSON, MS 39216-4721
(601) 366-7396
(610) 366-7549
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
1807-78
MS
Other
Enumeration date
10/23/2006
Last updated
08/22/2020
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