Provider Demographics
NPI:1194124750
Name:AGUILAR, JONATHAN EMMANUEL (DDS)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:EMMANUEL
Last Name:AGUILAR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 FULTON ST STE 401
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-2661
Mailing Address - Country:US
Mailing Address - Phone:940-566-5332
Mailing Address - Fax:940-381-0662
Practice Address - Street 1:1300 FULTON ST STE 401
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-2661
Practice Address - Country:US
Practice Address - Phone:940-566-5332
Practice Address - Fax:940-381-0662
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-20
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29990122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist