MEDICARE: DR. JAMES ROCEL GUERRERO PUGEDA DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	56836	CA

General Provider Information

NPI Number	:	1821260795
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES ROCEL GUERRERO PUGEDA DDS

Provider Business Mailing Address
First Line	:	2370 MARITIME DRIVE
Second Line	:
City	:	ELK GROVE
State	:	CA
Zip	:	95758-3639
Country	:	US
Telephone Number	:	916-446-7768
Fax Number	:	916-446-9014

Provider Business Practice Location Address
First Line	:	2370 MARITIME DRIVE
Second Line	:
City	:	ELK GROVE
State	:	CA
Zip	:	95758-3639
Country	:	US
Telephone Number	:	916-446-7768
Fax Number	:	916-446-9014

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2008
Last Update Date	:	10/25/2022

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