Provider Demographics
NPI:1376715276
Name:IM, AARON (DMD)
Entity type:Individual
Prefix:DR
First Name:AARON
Middle Name:
Last Name:IM
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 1:10 MARKET SQ
Mailing Address - Street 2:SUITE 3
Mailing Address - City:SOUTH PARIS
Mailing Address - State:ME
Mailing Address - Zip Code:04281-1534
Mailing Address - Country:US
Mailing Address - Phone:207-743-8701
Mailing Address - Fax:
Practice Address - Street 1:10 MARKET SQ
Practice Address - Street 2:SUITE 3
Practice Address - City:SOUTH PARIS
Practice Address - State:ME
Practice Address - Zip Code:04281-1534
Practice Address - Country:US
Practice Address - Phone:207-743-8701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-31
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEDEN40591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice