Provider Demographics
NPI:1093947525
Name:FELIX J AGUTO, DDS, PA
Entity Type:Organization
Organization Name:FELIX J AGUTO, DDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FELIX
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:AGUTO
Authorized Official - Suffix:III
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-645-6556
Mailing Address - Street 1:3460 OLD WASHINGTON RD
Mailing Address - Street 2:SUITE #200
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602-3240
Mailing Address - Country:US
Mailing Address - Phone:301-645-6556
Mailing Address - Fax:301-638-3131
Practice Address - Street 1:3460 OLD WASHINGTON RD
Practice Address - Street 2:SUITE #200
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-3240
Practice Address - Country:US
Practice Address - Phone:301-645-6556
Practice Address - Fax:301-638-3131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-18
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD11168122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty