Provider Demographics
NPI:1205834876
Name:ARONS, MARVIN SHIELD (MD, DMD)
Entity Type:Individual
Prefix:DR
First Name:MARVIN
Middle Name:SHIELD
Last Name:ARONS
Suffix:
Gender:M
Credentials:MD, DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 AMITY RD.
Mailing Address - Street 2:SUITE 107
Mailing Address - City:WOODBRIDGE
Mailing Address - State:CT
Mailing Address - Zip Code:06525-1439
Mailing Address - Country:US
Mailing Address - Phone:203-228-5123
Mailing Address - Fax:203-228-5124
Practice Address - Street 1:245 AMITY RD.
Practice Address - Street 2:SUITE 107
Practice Address - City:WOODBRIDGE
Practice Address - State:CT
Practice Address - Zip Code:06525-1439
Practice Address - Country:US
Practice Address - Phone:203-228-5123
Practice Address - Fax:203-228-5124
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2010-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT009147174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTC59855Medicare UPIN
CT240000009Medicare ID - Type Unspecified