Provider Demographics
NPI:1710188925
Name:RIVERA PEREZ, LUZ INES (DMD)
Entity Type:Individual
Prefix:DR
First Name:LUZ INES
Middle Name:
Last Name:RIVERA PEREZ
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 1:19-5 CALLE 28
Mailing Address - Street 2:URB. MIRAFLORES
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00957-3736
Mailing Address - Country:US
Mailing Address - Phone:787-509-5711
Mailing Address - Fax:
Practice Address - Street 1:19-5 CALLE 28
Practice Address - Street 2:URB. MIRAFLORES
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00957-3736
Practice Address - Country:US
Practice Address - Phone:787-509-5711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR23781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice