Provider Demographics
NPI:1457443285
Name:AREVALO, OSCAR A (DDS)
Entity Type:Individual
Prefix:DR
First Name:OSCAR
Middle Name:A
Last Name:AREVALO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:300 S BISCAYNE BLVD
Mailing Address - Street 2:APT 3310
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33131-5312
Mailing Address - Country:US
Mailing Address - Phone:267-738-2600
Mailing Address - Fax:
Practice Address - Street 1:3601 NW 107TH AVE
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-4377
Practice Address - Country:US
Practice Address - Phone:305-418-7781
Practice Address - Fax:305-662-8314
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLDN194481223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry