=====================================================
General NPI Number Information
=====================================================
NPI Number | 1710275235
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | VIGARNY A ARGUELLO JR. D.M.D
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/18/2011
-----------------------------------------------------
Last Update Date | 09/18/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 100 N STATE ROAD 7 SUITE 300
-----------------------------------------------------
City | MARGATE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33063-4520
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-532-1274
-----------------------------------------------------
Fax | 954-532-1797
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 100 N STATE ROAD 7 SUITE 300
-----------------------------------------------------
City | MARGATE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33063-4520
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-532-1274
-----------------------------------------------------
Fax | 954-532-1797
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number | DN19421
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------