Provider Demographics
NPI:1679195317
Name:MANOS, AARON A (DDS)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:A
Last Name:MANOS
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 1:6161 ROCKSIDE CIR NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-3786
Mailing Address - Country:US
Mailing Address - Phone:330-268-4762
Mailing Address - Fax:
Practice Address - Street 1:1922 W MAIN ST
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45373-1017
Practice Address - Country:US
Practice Address - Phone:937-332-8900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-16
Last Update Date:2020-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.026118122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist