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:
Health care specialties
Specialty | Code | License # | 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 11 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
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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