Provider Demographics
NPI:1437352176
Name:JARQUIN, ALVARO JAVIER (DDS)
Entity Type:Individual
Prefix:
First Name:ALVARO
Middle Name:JAVIER
Last Name:JARQUIN
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 1:8410 W FLAGLER ST
Mailing Address - Street 2:SUITE 110-B
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2092
Mailing Address - Country:US
Mailing Address - Phone:305-221-1230
Mailing Address - Fax:305-221-1540
Practice Address - Street 1:8410 W FLAGLER ST
Practice Address - Street 2:SUITE 110-B
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2092
Practice Address - Country:US
Practice Address - Phone:305-221-1230
Practice Address - Fax:305-221-1540
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN-151801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice