Provider Demographics
NPI:1922566827
Name:BELLO-RIVERA, CAROLINA ANGELICA (DMD)
Entity Type:Individual
Prefix:MISS
First Name:CAROLINA
Middle Name:ANGELICA
Last Name:BELLO-RIVERA
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 1:37 CALLE ALBERTO RICCI
Mailing Address - Street 2:
Mailing Address - City:PATILLAS
Mailing Address - State:PR
Mailing Address - Zip Code:00723-2851
Mailing Address - Country:US
Mailing Address - Phone:787-839-4160
Mailing Address - Fax:
Practice Address - Street 1:37 CALLE ALBERTO RICCI
Practice Address - Street 2:
Practice Address - City:PATILLAS
Practice Address - State:PR
Practice Address - Zip Code:00723-2851
Practice Address - Country:US
Practice Address - Phone:878-394-1607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-10
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PR33501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program