Healthcare Provider Details

I. General information

NPI: 1932298197
Provider Name (Legal Business Name): ALFREDO AGUIRRE DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 05/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3435 MAIN ST 355 SQUIRE HALL, SUNYAB
BUFFALO NY
14214-3001
US

IV. Provider business mailing address

3435 MAIN ST 355 SQUIRE HALL, SUNYAB
BUFFALO NY
14214-3001
US

V. Phone/Fax

Practice location:
  • Phone: 716-829-3553
  • Fax: 716-829-3554
Mailing address:
  • Phone: 716-829-3553
  • Fax: 716-829-3554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0106X
TaxonomyOral and Maxillofacial Pathology Dentistry
License Number049560-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: