MEDICARE: DR L ROMAGUERA-PAZMINO DMD PA

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	22DI01584400	NJ

General Provider Information

NPI Number	:	1295009652
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR L ROMAGUERA-PAZMINO DMD PA

Provider Business Mailing Address
First Line	:	526 42ND ST
Second Line	:
City	:	UNION CITY
State	:	NJ
Zip	:	07087-2989
Country	:	US
Telephone Number	:	201-867-5160
Fax Number	:	201-867-9979

Provider Business Practice Location Address
First Line	:	526 42ND ST
Second Line	:
City	:	UNION CITY
State	:	NJ
Zip	:	07087-2989
Country	:	US
Telephone Number	:	201-867-5160
Fax Number	:	201-867-9979

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. LEYLA ROMAGUERA-PAZMINO
Credential	:	D.M.D.
Telephone Number	:	201-867-5160

Provider Enumeration Date	:	03/02/2012
Last Update Date	:	03/02/2012

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