Rivera, Rafael

Rivera, Rafael is an sole proprietor health care provider with primary practice located at 4901 N Tryon St , Charlotte NC 28213-7033. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Rivera, Rafael can be contacted via phone (704) 921-0204.

Contact Information

Primary practice address
4901 N Tryon St Charlotte NC 28213-7033
Phone: (704) 921-0204
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 6870 North Carolina

Profile Details

NPI number 1013912427
LBN Legal business name Rivera, Rafael
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 14th, 2005
Last updated Mar 12th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013912427 NPPES
North Carolina Other 902HT BLUE CROSS BLUE SHIELD NC
North Carolina MEDICAID 89014NG BLUE CROSS BLUE SHIELD NC

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