NPI 1700398021

Jonathan Rivera, N

Practitioner Dental Laboratory Technician Fort Irwin, CA

Practice location

Address: 2605 Saint Mihiel St, Fort Irwin, CA 92310-1654
Phone: (615) 663-2003

Registered specialties

Dental Laboratory Technician Primary

Dental Providers Taxonomy 126900000X

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Registry record

NPI: 1700398021
Entity type: Individual
Sex (as registered): Male
NPI issued: 26 Oct 2017
Record last updated: 13 Dec 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.