Provider Demographics
NPI:1336638980
Name:ARCIA ROSALES, JOSE ALBERTO (DDS)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:ALBERTO
Last Name:ARCIA ROSALES
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 1:50 MINORCA AVE APT 1014
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-4565
Mailing Address - Country:US
Mailing Address - Phone:585-957-8756
Mailing Address - Fax:
Practice Address - Street 1:4011 W FLAGLER ST STE 201
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-1643
Practice Address - Country:US
Practice Address - Phone:585-957-8757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-08
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice