Provider Demographics
NPI:1235404096
Name:ROUNDY, AARON PRESTON (DDS)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:PRESTON
Last Name:ROUNDY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7138 HIGHLAND DR STE 215
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD HEIGHTS
Mailing Address - State:UT
Mailing Address - Zip Code:84121-3784
Mailing Address - Country:US
Mailing Address - Phone:801-943-9194
Mailing Address - Fax:801-943-1810
Practice Address - Street 1:7138 HIGHLAND DR STE 215
Practice Address - Street 2:
Practice Address - City:COTTONWOOD HEIGHTS
Practice Address - State:UT
Practice Address - Zip Code:84121-3784
Practice Address - Country:US
Practice Address - Phone:801-943-9194
Practice Address - Fax:801-943-1810
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-13
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7718138-99221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice