Provider Demographics
NPI:1073652509
Name:VAKULA-ROLLINS, AIMEE DENISE (DDS)
Entity Type:Individual
Prefix:DR
First Name:AIMEE
Middle Name:DENISE
Last Name:VAKULA-ROLLINS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7421 WHIPPOORWILL LN
Mailing Address - Street 2:
Mailing Address - City:DAVISON
Mailing Address - State:MI
Mailing Address - Zip Code:48423-3178
Mailing Address - Country:US
Mailing Address - Phone:734-358-3946
Mailing Address - Fax:
Practice Address - Street 1:1044 N IRISH RD
Practice Address - Street 2:SUITE B
Practice Address - City:DAVISON
Practice Address - State:MI
Practice Address - Zip Code:48423-2209
Practice Address - Country:US
Practice Address - Phone:810-653-4447
Practice Address - Fax:810-653-7988
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010174771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice