Provider Demographics
NPI:1003975798
Name:JOHN L. AURELIA, D.D.S., PLLC
Entity Type:Organization
Organization Name:JOHN L. AURELIA, D.D.S., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:L
Authorized Official - Last Name:AURELIA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:248-651-6810
Mailing Address - Street 1:804 N. MAIN ST
Mailing Address - Street 2:SUITE 201A
Mailing Address - City:ROCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48307
Mailing Address - Country:US
Mailing Address - Phone:248-651-6810
Mailing Address - Fax:248-651-0697
Practice Address - Street 1:804 N. MAIN ST
Practice Address - Street 2:SUITE 201A
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48307
Practice Address - Country:US
Practice Address - Phone:248-651-6810
Practice Address - Fax:248-651-0697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty