MEDICARE: AURORA FERNANDEZ SORDELLI DDS, MSD

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	20268	TX

General Provider Information

NPI Number	:	1215060454
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AURORA FERNANDEZ SORDELLI DDS, MSD

Provider Business Mailing Address
First Line	:	1035 DAIRY ASHFORD ST
Second Line	:	#234
City	:	HOUSTON
State	:	TX
Zip	:	77079-4608
Country	:	US
Telephone Number	:	281-759-2929
Fax Number	:	281-759-0907

Provider Business Practice Location Address
First Line	:	1035 DAIRY ASHFORD ST
Second Line	:	#234
City	:	HOUSTON
State	:	TX
Zip	:	77079-4608
Country	:	US
Telephone Number	:	281-759-2929
Fax Number	:	281-759-0907

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

Provider Enumeration Date	:	03/14/2007
Last Update Date	:	07/08/2007

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