Provider Demographics
NPI:1033318563
Name:CAMERINO, ANGELO MAIGUE (DDS)
Entity type:Individual
Prefix:DR
First Name:ANGELO
Middle Name:MAIGUE
Last Name:CAMERINO
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 1:1720 JET STREAM DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80921-3938
Mailing Address - Country:US
Mailing Address - Phone:719-481-8373
Mailing Address - Fax:719-481-8302
Practice Address - Street 1:1720 JET STREAM DR
Practice Address - Street 2:SUITE 110
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80921-3938
Practice Address - Country:US
Practice Address - Phone:719-481-8373
Practice Address - Fax:719-481-8302
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-14
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9469122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist