MEDICARE: ROBERT MARI G RAMOS DDS INC

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	122300000X	Dentist	49397	CA

General Provider Information

NPI Number	:	1114133824
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT MARI G RAMOS DDS INC

Provider Business Mailing Address
First Line	:	1249 NORTH GRAND AVE
Second Line	:
City	:	WALNUT
State	:	CA
Zip	:	91789
Country	:	US
Telephone Number	:	909-444-9488
Fax Number	:	909-444-9788

Provider Business Practice Location Address
First Line	:	1249 NORTH GRAND AVE
Second Line	:
City	:	WALNUT
State	:	CA
Zip	:	91789
Country	:	US
Telephone Number	:	909-444-9488
Fax Number	:	909-444-9788

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ROBERT MARI GUERRERO RAMOS
Credential	:	DDS
Telephone Number	:	909-444-9488

Provider Enumeration Date	:	05/16/2007
Last Update Date	:	01/11/2016

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