Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 10098 | MN |
NPI | 1063573590 |
---|---|
Provider Name | Dr. Ramon Aguirre |
First Address | Plymouth, MN 55446-3827 |
Second Address | Coon Rapids, MN 55433-2569 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2006 |
Last Update Date | 08/07/2007 |