Provider Demographics
NPI:1598881450
Name:GROSS, AARON M (DMD)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:M
Last Name:GROSS
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 1:1240 WHITNEY AVE
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06517-2813
Mailing Address - Country:US
Mailing Address - Phone:203-287-0666
Mailing Address - Fax:203-288-1851
Practice Address - Street 1:1240 WHITNEY AVE
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06517-2813
Practice Address - Country:US
Practice Address - Phone:203-287-0666
Practice Address - Fax:203-288-1851
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT88021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice