Robert W.rives, D.d.s., P.a. | |
1445 Lelia Dr Jackson MS 39216-4721 | |
(601) 366-7396 | |
(610) 366-7549 |
Full Name | Robert W.rives, D.d.s., P.a. |
---|---|
Speciality | Dentist - Periodontics |
Location | 1445 Lelia Dr, Jackson, Mississippi |
Authorized Official Name and Position | Robert Wayne Rives (OWNER) |
Authorized Official Contact | 6013667396 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Robert W.rives, D.d.s., P.a. 1445 Lelia Dr Jackson MS 39216-4721 Ph: (601) 366-7396 | Robert W.rives, D.d.s., P.a. 1445 Lelia Dr Jackson MS 39216-4721 Ph: (601) 366-7396 |
NPI Number | 1952484701 |
---|---|
Provider Enumeration Date | 10/23/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1952484701 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223P0300X | Dentist - Periodontics | 1807-78 (Mississippi) | Primary |
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