Provider Demographics
NPI:1568976389
Name:AGUILAR, JUAN ARMANDO (DDS)
Entity Type:Individual
Prefix:DR
First Name:JUAN
Middle Name:ARMANDO
Last Name:AGUILAR
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 1:6101 GATEWAY WEST 520-146
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925
Mailing Address - Country:US
Mailing Address - Phone:915-239-7490
Mailing Address - Fax:915-239-7490
Practice Address - Street 1:AVENIDA AMERICAS 1507 NORTE
Practice Address - Street 2:COL. AMERICAS
Practice Address - City:JUAREZ
Practice Address - State:CHIHUAHUA
Practice Address - Zip Code:32575
Practice Address - Country:MX
Practice Address - Phone:915-239-7490
Practice Address - Fax:915-239-7490
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-01
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ17145941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice