Healthcare Provider Details

I. General information

NPI: 1710102801
Provider Name (Legal Business Name): SERGIO ARMANDO ROMERO DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 AV AMERICAS SUITE 9
CO JUAREZ CHIHUAHUA
32300
MX

IV. Provider business mailing address

1120 WILL RAND DR
EL PASO TX
79912-7620
US

V. Phone/Fax

Practice location:
  • Phone: 011526566161616
  • Fax:
Mailing address:
  • Phone: 915-449-8589
  • Fax: 915-833-8796

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number1311768
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: