Provider Demographics
NPI:1093995144
Name:ROCA, AURELIO ANTONIO (DDS)
Entity Type:Individual
Prefix:
First Name:AURELIO
Middle Name:ANTONIO
Last Name:ROCA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3138 N. 10THST.
Mailing Address - Street 2:SUITE 301
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22201
Mailing Address - Country:US
Mailing Address - Phone:703-522-2600
Mailing Address - Fax:
Practice Address - Street 1:3138 10TH ST N
Practice Address - Street 2:SUITE 301
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22201-2160
Practice Address - Country:US
Practice Address - Phone:703-522-2600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-06
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010054661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice