Provider Demographics
NPI:1346249893
Name:RIVERA-NAVARRO, LUIS R (DMD)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:R
Last Name:RIVERA-NAVARRO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 56
Mailing Address - Street 2:
Mailing Address - City:CANOVANAS
Mailing Address - State:PR
Mailing Address - Zip Code:00729-0056
Mailing Address - Country:US
Mailing Address - Phone:787-463-9074
Mailing Address - Fax:787-957-7836
Practice Address - Street 1:CALLE 2 G-42
Practice Address - Street 2:VILLAS DORADAS
Practice Address - City:CANOVANAS
Practice Address - State:PR
Practice Address - Zip Code:00729
Practice Address - Country:US
Practice Address - Phone:787-463-9074
Practice Address - Fax:787-957-7836
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-18
Last Update Date:2013-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice