Provider Demographics
NPI:1881848000
Name:PAYNE, AARON RANDOLPH (DDS)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:RANDOLPH
Last Name:PAYNE
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 1:745 S CHURCH ST STE 309
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130-4963
Mailing Address - Country:US
Mailing Address - Phone:615-895-8577
Mailing Address - Fax:
Practice Address - Street 1:745 S CHURCH ST STE 309
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-4963
Practice Address - Country:US
Practice Address - Phone:615-895-8577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-14
Last Update Date:2008-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS0069251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice