Provider Demographics
NPI:1467810465
Name:AARON, STEPHANIE NOEL
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:NOEL
Last Name:AARON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 N ELM AVE
Mailing Address - Street 2:
Mailing Address - City:ALDAN
Mailing Address - State:PA
Mailing Address - Zip Code:19018-3110
Mailing Address - Country:US
Mailing Address - Phone:610-322-3270
Mailing Address - Fax:
Practice Address - Street 1:4130 BLOOMFIELD AVE
Practice Address - Street 2:
Practice Address - City:DREXEL HILL
Practice Address - State:PA
Practice Address - Zip Code:19026-3803
Practice Address - Country:US
Practice Address - Phone:610-284-4770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-04
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADH072469124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist