Provider Demographics
NPI:1841459245
Name:RIVERA, JOSE FRANCISCO (DMD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:FRANCISCO
Last Name:RIVERA
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:PO BOX 193154
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919-3154
Mailing Address - Country:US
Mailing Address - Phone:787-645-8214
Mailing Address - Fax:
Practice Address - Street 1:107 CALLE HIJA DEL CARIBE
Practice Address - Street 2:URB. EL VEDADO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3204
Practice Address - Country:US
Practice Address - Phone:787-759-6881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-02
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1096122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist