Provider Demographics
NPI:1093829020
Name:ADEN, BYRON LYNN
Entity Type:Individual
Prefix:DR
First Name:BYRON
Middle Name:LYNN
Last Name:ADEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2857 INDEPENDENCE ST
Mailing Address - Street 2:
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63703-5015
Mailing Address - Country:US
Mailing Address - Phone:573-334-4500
Mailing Address - Fax:573-334-5560
Practice Address - Street 1:2857 INDEPENDENCE ST
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63703-5015
Practice Address - Country:US
Practice Address - Phone:573-334-4500
Practice Address - Fax:573-334-5560
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0152251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice