MEDICARE: DR. ARIELLE ROLON DDS

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	059771	NY

General Provider Information

NPI Number	:	1871089755
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARIELLE ROLON DDS

Provider Business Mailing Address
First Line	:	1200 STATE ROUTE 208 STE 4
Second Line	:
City	:	MONROE
State	:	NY
Zip	:	10950-4649
Country	:	US
Telephone Number	:	516-410-4134
Fax Number	:

Provider Business Practice Location Address
First Line	:	1200 STATE ROUTE 208 STE 4
Second Line	:
City	:	MONROE
State	:	NY
Zip	:	10950-4649
Country	:	US
Telephone Number	:	516-410-4134
Fax Number	:

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

Provider Enumeration Date	:	07/03/2018
Last Update Date	:	05/05/2023

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