Provider Demographics
NPI:1164818548
Name:AQUINO, ALVIN (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALVIN
Middle Name:
Last Name:AQUINO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 NIAGARA ST
Mailing Address - Street 2:SUITE 3A
Mailing Address - City:TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14150-1104
Mailing Address - Country:US
Mailing Address - Phone:716-343-6711
Mailing Address - Fax:716-343-6710
Practice Address - Street 1:1040 US HIGHWAY 1 STE 103
Practice Address - Street 2:
Practice Address - City:AVENEL
Practice Address - State:NJ
Practice Address - Zip Code:07001-1539
Practice Address - Country:US
Practice Address - Phone:732-582-4224
Practice Address - Fax:732-482-4211
Is Sole Proprietor?:No
Enumeration Date:2015-04-12
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY058648122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice