MEDICARE: DR. DENNIS EUGENE ARAGON D.D.S

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	1223G0001X	General Practice Dentistry	D1391	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	111044	OTHER	NM	UNITED CONCORDIA

General Provider Information

NPI Number	:	1659395408
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENNIS EUGENE ARAGON D.D.S

Provider Business Mailing Address
First Line	:	800 MILLS AVE
Second Line	:
City	:	LAS VEGAS
State	:	NM
Zip	:	87701-4046
Country	:	US
Telephone Number	:	505-454-0631
Fax Number	:	505-454-0236

Provider Business Practice Location Address
First Line	:	800 MILLS AVE
Second Line	:	DENNIS E. ARAGON, D.D. S
City	:	LAS VEGAS
State	:	NM
Zip	:	87701-4046
Country	:	US
Telephone Number	:	505-454-0631
Fax Number	:	505-454-0236

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

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	07/08/2007

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