Provider Demographics
NPI:1932384229
Name:PICON, AURA M (DDS)
Entity Type:Individual
Prefix:DR
First Name:AURA
Middle Name:M
Last Name:PICON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13590 SW 134TH AVE
Mailing Address - Street 2:STE. 112
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-4561
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13590 SW 134 AVE.
Practice Address - Street 2:SUITE 112
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-4575
Practice Address - Country:US
Practice Address - Phone:305-506-1300
Practice Address - Fax:305-506-1301
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-04
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN17825122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist