Provider Demographics
NPI:1073224887
Name:AERO DENTAL PC
Entity Type:Organization
Organization Name:AERO DENTAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-550-4590
Mailing Address - Street 1:401 COMMERCE DR STE 108
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19034-2724
Mailing Address - Country:US
Mailing Address - Phone:215-550-4590
Mailing Address - Fax:
Practice Address - Street 1:1209 WARD AVE
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-4200
Practice Address - Country:US
Practice Address - Phone:610-998-6310
Practice Address - Fax:215-825-8191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-13
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty