Provider Demographics
NPI:1831914035
Name:FLOR L VIVAR ROBLES DENTIST PLLC
Entity type:Organization
Organization Name:FLOR L VIVAR ROBLES DENTIST PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FLOR
Authorized Official - Middle Name:L
Authorized Official - Last Name:VIVAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:516-362-8343
Mailing Address - Street 1:216 BEACH 20TH ST
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-3618
Mailing Address - Country:US
Mailing Address - Phone:718-327-8435
Mailing Address - Fax:
Practice Address - Street 1:216 BEACH 20TH ST
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-3618
Practice Address - Country:US
Practice Address - Phone:718-327-8435
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental