MEDICARE: CENTRO ORTODONTICO DEL NORTE

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	1445	PR

General Provider Information

NPI Number	:	1568902120
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRO ORTODONTICO DEL NORTE

Provider Business Mailing Address
First Line	:	560 AVE SAN LUIS STE 1
Second Line	:
City	:	ARECIBO
State	:	PR
Zip	:	00612-3640
Country	:	US
Telephone Number	:	787-878-5550
Fax Number	:	787-878-5655

Provider Business Practice Location Address
First Line	:	560 AVE SAN LUIS STE 1
Second Line	:
City	:	ARECIBO
State	:	PR
Zip	:	00612-3640
Country	:	US
Telephone Number	:	787-878-5550
Fax Number	:	787-878-5655

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RICARDO R ROSSY
Credential	:	DMD
Telephone Number	:	787-854-0887

Provider Enumeration Date	:	03/02/2017
Last Update Date	:	03/02/2017

Similar Medicare Providers

1487611109 — DR. LUIS GONZALEZ-MORALES D.M.D., M.S.
Practice Location Address:

556 AVE SAN LUIS
ARECIBO, PR
00612-3640

Practice Phone: 787-878-0901
Practice Fax:

1336292366 — DR. LUIS S GALARZA ESCOBAR D.M.D.
Practice Location Address:

560 AVE SAN LUIS
ARECIBO, PR
00612-3640

Practice Phone: 787-878-4102
Practice Fax: 787-878-4107

1568669711 — ROSA M FERNANDEZ D.M.D.
Practice Location Address:

560 AVE SAN LUIS
ARECIBO, PR
00612-3640

Practice Phone: 787-878-4102
Practice Fax: 787-878-4107

1265192447 — CENTRO ORTODONTICO DE ARECIBO
Practice Location Address:

560 AVE SAN LUIS STE 1
ARECIBO, PR
00612-3640

Practice Phone: 787-878-5550
Practice Fax: 787-878-5655

1598614208 — ASA CARDIOLOGY LLC
Practice Location Address:

SUITE 109 CARR 129 KM 1.0 , AVE SAN LUIS
ARECIBO, PR
00612-3373

Practice Phone: 787-650-7272
Practice Fax:

1962131565 — MELISSA MARIE OWEN JIMENEZ MD
Practice Location Address:

URB VILLA LOS SANTOS, V1 CALLE 16
ARECIBO, PR
00612-3112

Practice Phone: 787-879-1585
Practice Fax: 787-815-2929

Directions to “CENTRO ORTODONTICO DEL NORTE ” Practice Location

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