MEDICARE: M. RAUFY DDS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	1223E0200X	Endodontics
2	1223P0300X	Periodontics
3	1223P0700X	Prosthodontics
4	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1851099048
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	M. RAUFY DDS, INC.

Provider Business Mailing Address
First Line	:	9750 MIRAMAR RD STE 380
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92126-4563
Country	:	US
Telephone Number	:	858-848-4180
Fax Number	:

Provider Business Practice Location Address
First Line	:	9750 MIRAMAR RD STE 380
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92126-4563
Country	:	US
Telephone Number	:	858-848-4180
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. MUZMML RAUFY
Credential	:	DDS
Telephone Number	:	858-848-4180

Provider Enumeration Date	:	02/17/2023
Last Update Date	:	02/17/2023

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