Provider Demographics
NPI:1629167788
Name:RIOS MERCADO, FRANCISCO JAVIER
Entity Type:Individual
Prefix:DR
First Name:FRANCISCO
Middle Name:JAVIER
Last Name:RIOS MERCADO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 N QUEEN ST
Mailing Address - Street 2:
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28501-4932
Mailing Address - Country:US
Mailing Address - Phone:252-522-5234
Mailing Address - Fax:252-523-9790
Practice Address - Street 1:324 N QUEEN ST
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28501-4932
Practice Address - Country:US
Practice Address - Phone:252-522-5234
Practice Address - Fax:252-523-9790
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2015-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16961223G0001X
NC99191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice