Provider Demographics
NPI:1992981252
Name:RIVERA, FRANCISCO J (DDS)
Entity type:Individual
Prefix:
First Name:FRANCISCO
Middle Name:J
Last Name:RIVERA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 WILL RAND DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-7620
Mailing Address - Country:US
Mailing Address - Phone:915-449-8589
Mailing Address - Fax:915-833-8796
Practice Address - Street 1:AVE AMERICAS 678-B
Practice Address - Street 2:
Practice Address - City:JUAREZ
Practice Address - State:CHIHUAHUA
Practice Address - Zip Code:32310
Practice Address - Country:MX
Practice Address - Phone:656-616-2672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-17
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX794883122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist