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General NPI Number Information
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NPI Number | 1649506213
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Entity Type | Individual
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Provider Name | OSCAR JESUS PEGUERO JR. D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/02/2009
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Last Update Date | 02/20/2017
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Provider Practice Location Address
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Address Line | 7000 SW 62ND AVE PENTHOUSE-E
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-4716
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Country | US
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Telephone | 305-666-6104
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Fax | 305-665-1136
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Provider Business Mailing Address
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Address Line | 7000 SW 62ND AVE PENTHOUSE-E
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-4716
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Country | US
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Telephone | 305-666-6104
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Fax | 305-665-1136
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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 | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | DN18826
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | DN1855256
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License Number State | MA
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