MEDICARE: DR. ALFREDO VARGAS 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	1080	PR

General Provider Information

NPI Number	:	1396748356
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALFREDO VARGAS DMD

Provider Business Mailing Address
First Line	:	PO BOX 1677
Second Line	:
City	:	CAGUAS
State	:	PR
Zip	:	00726-1677
Country	:	US
Telephone Number	:	787-743-1998
Fax Number	:

Provider Business Practice Location Address
First Line	:	26 CALLE ACOSTA
Second Line	:
City	:	CAGUAS
State	:	PR
Zip	:	00725-2650
Country	:	US
Telephone Number	:	787-743-1998
Fax Number	:

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

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	12/07/2007

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