MEDICARE: AARON WAYNE ENGELS DDS

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	1223P0221X	Pediatric Dentistry	20662	TX

General Provider Information

NPI Number	:	1437119484
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AARON WAYNE ENGELS DDS

Provider Business Mailing Address
First Line	:	12229 MONTCLAIR BND
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78732-1229
Country	:	US
Telephone Number	:	512-269-6374
Fax Number	:

Provider Business Practice Location Address
First Line	:	12229 MONTCLAIR BND
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78732-1229
Country	:	US
Telephone Number	:	512-269-6374
Fax Number	:

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

Provider Enumeration Date	:	03/24/2006
Last Update Date	:	01/04/2010

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