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General NPI Number Information
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NPI Number | 1922364439
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Entity Type | Individual
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Provider Name | ARIEL O OTERO-RODRIGUEZ DMD
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Gender | Male
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Dates
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Enumeration Date | 04/09/2012
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Last Update Date | 01/10/2024
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Provider Practice Location Address
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Address Line | 221 KEARNY AVE
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City | KEARNY
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State | NJ
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Zip | 07032-2437
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Country | US
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Telephone | 201-299-6393
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Fax | 201-299-6394
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Provider Business Mailing Address
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Address Line | 221 KEARNY AVE
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City | KEARNY
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State | NJ
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Zip | 07032-2437
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Country | US
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Telephone | 201-299-6393
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Fax | 201-299-6394
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 22DI02754900
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 3177
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License Number State | PR
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Taxonomy #3
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 059089
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License Number State | NY
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