Provider Demographics
NPI:1235701251
Name:AAA DENTAL PC
Entity Type:Organization
Organization Name:AAA DENTAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TYANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:YAMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-284-4337
Mailing Address - Street 1:477 TOWN FARM RD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MA
Mailing Address - Zip Code:01083-7990
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1045 THORNDIKE ST
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:MA
Practice Address - Zip Code:01069-1504
Practice Address - Country:US
Practice Address - Phone:413-284-4337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-12
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty