Provider Demographics
NPI:1528484136
Name:E VARGAS DDS & ASSOCIATES LLC
Entity type:Organization
Organization Name:E VARGAS DDS & ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDUARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:VARGAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-390-9772
Mailing Address - Street 1:17000 SCIENCE DR
Mailing Address - Street 2:SUITE 206
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20715-4420
Mailing Address - Country:US
Mailing Address - Phone:301-464-4672
Mailing Address - Fax:
Practice Address - Street 1:17000 SCIENCE DR
Practice Address - Street 2:SUITE 206
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-4420
Practice Address - Country:US
Practice Address - Phone:301-464-4672
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-07
Last Update Date:2014-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD10682122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty