Provider Demographics
NPI:1497826598
Name:RIOS, LILLIAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:LILLIAN
Middle Name:
Last Name:RIOS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 CALLE REY RICARDO
Mailing Address - Street 2:LA VILLA DE TORRIMAR
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-3226
Mailing Address - Country:US
Mailing Address - Phone:787-720-3087
Mailing Address - Fax:
Practice Address - Street 1:19 CALLE LAS MERCEDES
Practice Address - Street 2:
Practice Address - City:COROZAL
Practice Address - State:PR
Practice Address - Zip Code:00783-1924
Practice Address - Country:US
Practice Address - Phone:787-859-2870
Practice Address - Fax:787-859-2870
Is Sole Proprietor?:No
Enumeration Date:2006-11-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice