MEDICARE: DR. PEDRO BENITO RODRIGUEZ 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	2040	PR

General Provider Information

NPI Number	:	1972503282
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PEDRO BENITO RODRIGUEZ D.M.D.

Provider Business Mailing Address
First Line	:	#107 AVE. GONZALEZ GIUSTI
Second Line	:	SUITE 306,CAPARRA GALLERY PLAZA
City	:	GUAYNABO
State	:	PR
Zip	:	00966
Country	:	US
Telephone Number	:	787-273-6810
Fax Number	:	787-273-0521

Provider Business Practice Location Address
First Line	:	#107 AVE. GONZALEZ GIUSTI
Second Line	:	SUITE 306,CAPARRA GALLERY PLAZA
City	:	GUAYNABO
State	:	PR
Zip	:	00966
Country	:	US
Telephone Number	:	787-273-6810
Fax Number	:	787-273-0521

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

Provider Enumeration Date	:	07/28/2005
Last Update Date	:	07/08/2007

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Directions to “ DR. PEDRO BENITO RODRIGUEZ D.M.D.” Practice Location

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