Provider Demographics
NPI:1619497062
Name:VAQUER, VANESA PAOLA (DMD)
Entity Type:Individual
Prefix:
First Name:VANESA
Middle Name:PAOLA
Last Name:VAQUER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3211 PALM WAY APT 2213
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-7888
Mailing Address - Country:US
Mailing Address - Phone:786-282-7284
Mailing Address - Fax:
Practice Address - Street 1:5920 W WILLIAM CANNON DR STE 6-210
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78749-2008
Practice Address - Country:US
Practice Address - Phone:512-215-4350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-26
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN227011223G0001X
TX357191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice