Provider Demographics
NPI:1083700777
Name:AIELLO, KATHERINE L (DDS)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:L
Last Name:AIELLO
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 1:3201 ROGERS AVENUE
Mailing Address - Street 2:SUITE 303
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043
Mailing Address - Country:US
Mailing Address - Phone:410-750-3583
Mailing Address - Fax:410-480-0290
Practice Address - Street 1:3201 ROGERS AVENUE
Practice Address - Street 2:SUITE 303
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043
Practice Address - Country:US
Practice Address - Phone:410-750-3583
Practice Address - Fax:410-480-0290
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD75411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice