Provider Demographics
NPI:1922067560
Name:RIVERA, MARIA VICTORIA (DMD)
Entity Type:Individual
Prefix:MISS
First Name:MARIA
Middle Name:VICTORIA
Last Name:RIVERA
Suffix:
Gender:F
Credentials:DMD
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Mailing Address - Street 1:139 CAMINO DE LAS CEIBAS
Mailing Address - Street 2:SABANERA DEL RIO
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778-5224
Mailing Address - Country:US
Mailing Address - Phone:787-751-5317
Mailing Address - Fax:787-759-5112
Practice Address - Street 1:200 GRAND BLVD LOS PRADOS
Practice Address - Street 2:PLAZA LOS PRADOS SUITE 804
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-626-6217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-22
Last Update Date:2020-10-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PR25991223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry