Provider Demographics
NPI:1669551214
Name:MCCANN, AARON THOMAS (DDS)
Entity type:Individual
Prefix:DR
First Name:AARON
Middle Name:THOMAS
Last Name:MCCANN
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 1:3615 SENECA ST STE O
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-3444
Mailing Address - Country:US
Mailing Address - Phone:716-675-4828
Mailing Address - Fax:
Practice Address - Street 1:3615 SENECA ST STE O
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-3444
Practice Address - Country:US
Practice Address - Phone:716-675-4828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0520521223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM42422370Medicaid
AZ105784Medicaid