Healthcare Provider Details

I. General information

NPI: 1891892170
Provider Name (Legal Business Name): AGUIRRE ORTHODONTICS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4031 NW 43RD ST
GAINESVILLE FL
32606-4598
US

IV. Provider business mailing address

4031 NW 43RD ST
GAINESVILLE FL
32606-4598
US

V. Phone/Fax

Practice location:
  • Phone: 352-376-7846
  • Fax: 352-376-9766
Mailing address:
  • Phone: 352-376-7846
  • Fax: 352-376-9766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number StateDC

VIII. Authorized Official

Name: DR. MICHAEL J AGUIRRE
Title or Position: PRESIDENT
Credential: DDS
Phone: 352-376-7846