Provider Demographics
NPI:1356662183
Name:WOOD, AARON AVERY (DDS)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:AVERY
Last Name:WOOD
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 1:572 BLACKHAWK LN
Mailing Address - Street 2:
Mailing Address - City:ALPINE
Mailing Address - State:UT
Mailing Address - Zip Code:84004-1825
Mailing Address - Country:US
Mailing Address - Phone:210-535-9353
Mailing Address - Fax:
Practice Address - Street 1:180 E 200 N
Practice Address - Street 2:
Practice Address - City:ALPINE
Practice Address - State:UT
Practice Address - Zip Code:84004-1626
Practice Address - Country:US
Practice Address - Phone:801-756-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-16
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0025507122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist