Provider Demographics
NPI:1386485746
Name:DENTAL AMIGO PC
Entity type:Organization
Organization Name:DENTAL AMIGO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ARMANDO
Authorized Official - Middle Name:AARON
Authorized Official - Last Name:JAUREGUI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:720-891-0017
Mailing Address - Street 1:5254 S IRELAND WAY
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80015-5436
Mailing Address - Country:US
Mailing Address - Phone:720-891-0017
Mailing Address - Fax:
Practice Address - Street 1:2780 S WADSWORTH BLVD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80227-3408
Practice Address - Country:US
Practice Address - Phone:720-891-0017
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-01
Last Update Date:2024-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty