Provider Demographics
NPI:1043686074
Name:DUFFY, AARON MADISON (DDS)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:MADISON
Last Name:DUFFY
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 1:8630 SIERRA COLLEGE BLVD
Mailing Address - Street 2:STE. 110
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-6062
Mailing Address - Country:US
Mailing Address - Phone:916-783-0244
Mailing Address - Fax:
Practice Address - Street 1:8630 SIERRA COLLEGE BLVD
Practice Address - Street 2:STE. 110
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-6062
Practice Address - Country:US
Practice Address - Phone:916-783-0244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-13
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA64875122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist