Provider Demographics
NPI:1487859062
Name:ROSARIO Z AGULAR
Entity Type:Organization
Organization Name:ROSARIO Z AGULAR
Other - Org Name:PEDIATRIC AND FAMILY DENTISTRY OF WOBURN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROSARIO
Authorized Official - Middle Name:Z
Authorized Official - Last Name:AGULAR
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:781-933-8380
Mailing Address - Street 1:7 ALFRED ST.
Mailing Address - Street 2:BALDWIN PARK II SUITE 210
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801
Mailing Address - Country:US
Mailing Address - Phone:781-933-8380
Mailing Address - Fax:781-933-8380
Practice Address - Street 1:7 ALFRED ST.
Practice Address - Street 2:BALDWIN PARK II SUITE 210
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801
Practice Address - Country:US
Practice Address - Phone:781-933-8380
Practice Address - Fax:781-933-8380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-15
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA130811223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9768726Medicaid
MA0244457Medicaid