Provider Demographics
NPI:1104111962
Name:ROCA, MIGUEL ARIEL (DMD)
Entity type:Individual
Prefix:DR
First Name:MIGUEL
Middle Name:ARIEL
Last Name:ROCA
Suffix:
Gender:
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 SCHOOL ST # CONDO1
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-5747
Mailing Address - Country:US
Mailing Address - Phone:401-999-1012
Mailing Address - Fax:401-633-6116
Practice Address - Street 1:700 SCHOOL ST # CONDO1
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-5747
Practice Address - Country:US
Practice Address - Phone:401-999-1012
Practice Address - Fax:401-633-6116
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-09
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RICDEN031231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice