Provider Demographics
NPI:1275573685
Name:ARGUELLO, CONNIE M (DDS)
Entity Type:Individual
Prefix:DR
First Name:CONNIE
Middle Name:M
Last Name:ARGUELLO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11358 MIRAMAR PKWY
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-5805
Mailing Address - Country:US
Mailing Address - Phone:954-442-0006
Mailing Address - Fax:954-442-0086
Practice Address - Street 1:11358 MIRAMAR PKWY
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-5805
Practice Address - Country:US
Practice Address - Phone:954-442-0006
Practice Address - Fax:954-442-0086
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL156181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice