MEDICARE: BILL ARDITO DDS

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

General Provider Information

NPI Number	:	1538629431
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BILL ARDITO DDS

Provider Business Mailing Address
First Line	:	3411 W CALLE TRES
Second Line	:
City	:	GREEN VALLEY
State	:	AZ
Zip	:	85622-5397
Country	:	US
Telephone Number	:	520-761-1600
Fax Number	:

Provider Business Practice Location Address
First Line	:	855 W BELL RD STE 600
Second Line	:
City	:	NOGALES
State	:	AZ
Zip	:	85621-4579
Country	:	US
Telephone Number	:	520-761-1600
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	DR. VITO MICHAEL ARDITO
Credential	:	DDS
Telephone Number	:	520-761-1600

Provider Enumeration Date	:	03/25/2019
Last Update Date	:	03/25/2019

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