MEDICARE: DR. MIGUEL ARIEL ROCA 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	CDEN03123	RI

General Provider Information

NPI Number	:	1104111962
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MIGUEL ARIEL ROCA DMD

Provider Business Mailing Address
First Line	:	700 SCHOOL ST # CONDO1
Second Line	:
City	:	PAWTUCKET
State	:	RI
Zip	:	02860-5747
Country	:	US
Telephone Number	:	401-999-1012
Fax Number	:	401-633-6116

Provider Business Practice Location Address
First Line	:	700 SCHOOL ST # CONDO1
Second Line	:
City	:	PAWTUCKET
State	:	RI
Zip	:	02860-5747
Country	:	US
Telephone Number	:	401-999-1012
Fax Number	:	401-633-6116

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

Provider Enumeration Date	:	06/09/2011
Last Update Date	:	05/13/2025

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