Provider Demographics
NPI:1508202847
Name:AURORA DENTAL CARE
Entity Type:Organization
Organization Name:AURORA DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:A
Authorized Official - Last Name:PETRONIO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:716-652-0190
Mailing Address - Street 1:92 GREY STREET
Mailing Address - Street 2:
Mailing Address - City:EAST AURORA
Mailing Address - State:NY
Mailing Address - Zip Code:14052
Mailing Address - Country:US
Mailing Address - Phone:716-652-0190
Mailing Address - Fax:716-652-2829
Practice Address - Street 1:92 GREY STREET
Practice Address - Street 2:
Practice Address - City:EAST AURORA
Practice Address - State:NY
Practice Address - Zip Code:14052
Practice Address - Country:US
Practice Address - Phone:716-652-0190
Practice Address - Fax:716-652-2829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-14
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty