| Jesse Rivas, Dds, Pa | |
|
811 N Macarthur Blvd Irving TX 75061-7325 | |
| (972) 254-4204 | |
| (972) 254-1183 |
| Full Name | Jesse Rivas, Dds, Pa |
|---|---|
| Speciality | Dentist |
| Location | 811 N Macarthur Blvd, Irving, Texas |
| Authorized Official Name and Position | Jesse Rivas (PRESIDENT/DENTIST) |
| Authorized Official Contact | 9722544204 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jesse Rivas, Dds, Pa 811 N Macarthur Blvd Irving TX 75061-7325 Ph: (972) 254-4204 | Jesse Rivas, Dds, Pa 811 N Macarthur Blvd Irving TX 75061-7325 Ph: (972) 254-4204 |
| NPI Number | 1457625865 |
|---|---|
| Provider Enumeration Date | 03/02/2012 |
| Last Update Date | 03/02/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457625865 | NPI | - | NPPES |
| 007920405 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 19348 (Texas) | Primary |
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