Provider Demographics
NPI:1174745897
Name:RIOS, EILEEN (DMD)
Entity type:Individual
Prefix:
First Name:EILEEN
Middle Name:
Last Name:RIOS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 VIA PORTICA
Mailing Address - Street 2:MONTE ALVERNIA
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-6804
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5 VIA PORTICA
Practice Address - Street 2:MONTE ALVERNIA
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-6804
Practice Address - Country:US
Practice Address - Phone:787-853-5644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR25591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice