MEDICARE: DR. RAMON ENRIQUE RAFFUCCI JR. DMD

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	1273	PR

General Provider Information

NPI Number	:	1952484743
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAMON ENRIQUE RAFFUCCI JR. DMD

Provider Business Mailing Address
First Line	:	VILLAS DE LAS AMERICAS
Second Line	:	B-15 BZ.50
City	:	SAN JUAN
State	:	PR
Zip	:	00927-0000
Country	:	US
Telephone Number	:	787-752-5315
Fax Number	:	787-752-5315

Provider Business Practice Location Address
First Line	:	KL-5 FIDALGO DIAZ AVE.
Second Line	:	VILLA FONTANA
City	:	CAROLINA
State	:	PR
Zip	:	00983-0000
Country	:	US
Telephone Number	:	787-752-5315
Fax Number	:	787-752-5315

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

Provider Enumeration Date	:	10/23/2006
Last Update Date	:	07/08/2007

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