Provider Demographics
NPI:1700188208
Name:BRODY, AARON (DMD)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:
Last Name:BRODY
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 1:514 CAPE MAY ST
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-4721
Mailing Address - Country:US
Mailing Address - Phone:201-321-3951
Mailing Address - Fax:
Practice Address - Street 1:514 CAPE MAY ST
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-4721
Practice Address - Country:US
Practice Address - Phone:201-321-3951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-03
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY055239122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist