MEDICARE: RICARDO J. PEREZ 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	1223G0001X	General Practice Dentistry	1781	PR

General Provider Information

NPI Number	:	1831192327
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICARDO J. PEREZ D.M.D.

Provider Business Mailing Address
First Line	:	RIO CRISTAL
Second Line	:	RJ-21 V. DEL PLATA
City	:	TRUJILLO ALTO
State	:	PR
Zip	:	00976
Country	:	US
Telephone Number	:	787-769-6880
Fax Number	:	787-760-7413

Provider Business Practice Location Address
First Line	:	IGNACIO ARZUAGA, 5 WEST
Second Line	:	5 WEST
City	:	CAROLINA
State	:	PR
Zip	:	00985
Country	:	US
Telephone Number	:	787-769-6880
Fax Number	:	787-760-7413

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

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	07/08/2007

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