Provider Demographics
NPI:1518032994
Name:RIVERA MARCANO, FELIX MANUEL (DMD)
Entity Type:Individual
Prefix:
First Name:FELIX
Middle Name:MANUEL
Last Name:RIVERA MARCANO
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:E24
Mailing Address - Street 2:LUIS MUNOZ MARIN NOTRE DAME
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725
Mailing Address - Country:US
Mailing Address - Phone:787-746-7488
Mailing Address - Fax:
Practice Address - Street 1:E24
Practice Address - Street 2:LUIS MUNOZ MARIN NOTRE DAME
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-746-7488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice