MEDICARE: DR. ARNALDO JUAN DE JESUS 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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	398	PR

General Provider Information

NPI Number	:	1538123690
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARNALDO JUAN DE JESUS DMD

Provider Business Mailing Address
First Line	:	1692 CALLE PARANA
Second Line	:	EL CEREZAL
City	:	SAN JUAN
State	:	PR
Zip	:	00926-3144
Country	:	US
Telephone Number	:	787-751-1593
Fax Number	:	787-764-9271

Provider Business Practice Location Address
First Line	:	1692 CALLE PARANA
Second Line	:	EL CEREZAL
City	:	SAN JUAN
State	:	PR
Zip	:	00926-3144
Country	:	US
Telephone Number	:	787-751-1593
Fax Number	:	787-764-9271

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

Provider Enumeration Date	:	04/14/2006
Last Update Date	:	07/08/2007

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