| NPI | 1144727017 |
|---|---|
| Former Legal Business Name | ROBERTO RIVERA |
| Entity Type | Organization |
| Authorized Contact | ROBERTO RIVERA Dentist 619-488-3200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: ZZ 6493905) |
| Enumeration Date | 2018-04-09 |
| Last Update Date | 2018-04-09 |