Provider Demographics
NPI:1407834666
Name:D'AURORA, MARIO E (DDS)
Entity Type:Individual
Prefix:
First Name:MARIO
Middle Name:E
Last Name:D'AURORA
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 1:2912 CONTESSA LN
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-1741
Mailing Address - Country:US
Mailing Address - Phone:814-833-7899
Mailing Address - Fax:
Practice Address - Street 1:3805 RASPBERRY ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16509-1321
Practice Address - Country:US
Practice Address - Phone:814-864-4807
Practice Address - Fax:814-866-5445
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-06
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS021953L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist