Provider Demographics
NPI:1548790330
Name:DR JAUREGUI DENTAL CARE CORP
Entity Type:Organization
Organization Name:DR JAUREGUI DENTAL CARE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GUILLERMO
Authorized Official - Middle Name:C
Authorized Official - Last Name:JAUREGUI RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:786-838-6218
Mailing Address - Street 1:5757 SW 8TH ST STE 115
Mailing Address - Street 2:
Mailing Address - City:WEST MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-5060
Mailing Address - Country:US
Mailing Address - Phone:305-269-1781
Mailing Address - Fax:
Practice Address - Street 1:5757 SW 8TH ST STE 115
Practice Address - Street 2:
Practice Address - City:WEST MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-5060
Practice Address - Country:US
Practice Address - Phone:305-269-1781
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN210551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty