Provider Demographics
NPI:1669560769
Name:RIVERA-HIDALGO, FRANCISCO (DMD)
Entity type:Individual
Prefix:DR
First Name:FRANCISCO
Middle Name:
Last Name:RIVERA-HIDALGO
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 1:1004 EDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-5809
Mailing Address - Country:US
Mailing Address - Phone:214-828-8154
Mailing Address - Fax:214-828-8411
Practice Address - Street 1:3302 GASTON AVE
Practice Address - Street 2:BAYLOR COLLEGE OF DENTISTRY ROOM 138A
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-2013
Practice Address - Country:US
Practice Address - Phone:214-828-8154
Practice Address - Fax:214-828-8411
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX150861223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics