Provider Demographics
NPI:1467692228
Name:ATWOOD, AARON M (DMD)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:M
Last Name:ATWOOD
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 E WINDMILL LN
Mailing Address - Street 2:STE 130
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-1843
Mailing Address - Country:US
Mailing Address - Phone:702-228-1106
Mailing Address - Fax:702-228-4106
Practice Address - Street 1:500 E WINDMILL LN
Practice Address - Street 2:STE 130
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-1843
Practice Address - Country:US
Practice Address - Phone:702-228-1106
Practice Address - Fax:702-228-4106
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-05
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5795122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist