MEDICARE: DR. VINCENT PAUL ARATA D.M.D.

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	4279	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	90968	OTHER	AL	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1831177484
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VINCENT PAUL ARATA D.M.D.

Provider Business Mailing Address
First Line	:	4900 MOFFETT RD
Second Line	:
City	:	MOBILE
State	:	AL
Zip	:	36618-2222
Country	:	US
Telephone Number	:	251-343-0404
Fax Number	:	251-343-7645

Provider Business Practice Location Address
First Line	:	4900 MOFFETT RD
Second Line	:
City	:	MOBILE
State	:	AL
Zip	:	36618-2222
Country	:	US
Telephone Number	:	251-343-0404
Fax Number	:	251-343-7645

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

Provider Enumeration Date	:	01/04/2006
Last Update Date	:	03/04/2020

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