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General NPI Number Information
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NPI Number | 1740577717
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Entity Type | Individual
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Provider Name | JOSE I AUNON
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Gender | Male
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Dates
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Enumeration Date | 06/29/2011
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Last Update Date | 06/29/2011
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Provider Practice Location Address
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Address Line | 6134 REDWOOD SQUARE CTR SUITE 202
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City | CENTREVILLE
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State | VA
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Zip | 20121-2642
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Country | US
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Telephone | 703-266-2483
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Fax | 703-266-9300
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Provider Business Mailing Address
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Address Line | 6134 REDWOOD SQUARE CTR SUITE 202
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City | CENTREVILLE
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State | VA
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Zip | 20121-2642
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Country | US
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Telephone | 703-266-2483
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Fax | 703-266-9300
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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 | 6816
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License Number State | VA
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