MEDICARE: DR. ASHLEY GUNNELL ARAGONA DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	D009193	AZ
2	122300000X	Dentist	28069	TX
3	122300000X	Dentist	7758098-9921	UT
4	122300000X	Dentist	DEN.00203550	CO

General Provider Information

NPI Number	:	1386942498
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ASHLEY GUNNELL ARAGONA DMD

Provider Business Mailing Address
First Line	:	2170 WICKES RD
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80919-4841
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2170 WICKES RD
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80919
Country	:	US
Telephone Number	:	214-697-3029
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/14/2011
Last Update Date	:	08/14/2018

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