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General NPI Number Information
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NPI Number | 1437671229
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Entity Type | Individual
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Provider Name | ALLAN RODRIGO JAUREGUI DMD
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Gender | Male
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Dates
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Enumeration Date | 07/13/2017
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Last Update Date | 07/20/2022
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Provider Practice Location Address
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Address Line | 1507 E COURT ST STE 107
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City | SEGUIN
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State | TX
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Zip | 78155-5265
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Country | US
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Telephone | 830-372-9979
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Fax |
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Provider Business Mailing Address
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Address Line | 19534 AZURE OAK
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City | SAN ANTONIO
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State | TX
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Zip | 78258-3114
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Country | US
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Telephone | 210-372-2029
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 33217
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 33217
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License Number State | TX
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