Provider Demographics
NPI:1053482984
Name:RIVES, FRANK DAVID (DDS)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:DAVID
Last Name:RIVES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:F
Other - Middle Name:DAVID
Other - Last Name:RIVES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:510 SOUTH MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MS
Mailing Address - Zip Code:39345-2619
Mailing Address - Country:US
Mailing Address - Phone:601-683-3148
Mailing Address - Fax:601-683-3149
Practice Address - Street 1:510 SOUTH MAIN ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MS
Practice Address - Zip Code:39345-2619
Practice Address - Country:US
Practice Address - Phone:601-683-3148
Practice Address - Fax:601-683-3149
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1614741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice