MEDICARE: ROBERT E. RIX D.D.S.

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	6174	MD

General Provider Information

NPI Number	:	1750569315
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT E. RIX D.D.S.

Provider Business Mailing Address
First Line	:	14334 OLD MARLBORO PIKE
Second Line	:
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20772-2840
Country	:	US
Telephone Number	:	301-627-3446
Fax Number	:	301-627-3468

Provider Business Practice Location Address
First Line	:	14334 OLD MARLBORO PIKE
Second Line	:
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20772-2840
Country	:	US
Telephone Number	:	301-627-3446
Fax Number	:	301-627-3468

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

Provider Enumeration Date	:	02/06/2008
Last Update Date	:	02/06/2008

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