MEDICARE: SANDRA ROJAS 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	DN19424	FL

General Provider Information

NPI Number	:	1619265790
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA ROJAS DMD

Provider Business Mailing Address
First Line	:	6346 LANTANA RD STE 68
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33463-6664
Country	:	US
Telephone Number	:	561-439-5100
Fax Number	:

Provider Business Practice Location Address
First Line	:	6346 LANTANA RD STE 68
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33463-6664
Country	:	US
Telephone Number	:	561-439-5100
Fax Number	:

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

Provider Enumeration Date	:	07/11/2011
Last Update Date	:	11/04/2019

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