Provider Demographics
NPI:1659485100
Name:DANNEGGER, AARON RICHARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:RICHARD
Last Name:DANNEGGER
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 1:636 W REPUBLIC RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-5818
Mailing Address - Country:US
Mailing Address - Phone:417-882-3200
Mailing Address - Fax:417-887-5189
Practice Address - Street 1:636 W REPUBLIC RD
Practice Address - Street 2:SUITE 120
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-5818
Practice Address - Country:US
Practice Address - Phone:417-882-3200
Practice Address - Fax:417-887-5189
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20001572441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice