Provider Demographics
NPI:1750587051
Name:MCCORMICK, AARON LEE (DDS)
Entity type:Individual
Prefix:DR
First Name:AARON
Middle Name:LEE
Last Name:MCCORMICK
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 W. 14TH ST. BLDG C
Mailing Address - Street 2:
Mailing Address - City:RIFLE
Mailing Address - State:CO
Mailing Address - Zip Code:81650
Mailing Address - Country:US
Mailing Address - Phone:970-945-2840
Mailing Address - Fax:970-945-2893
Practice Address - Street 1:195 W. 14TH ST, BLDG C
Practice Address - Street 2:
Practice Address - City:RIFLE
Practice Address - State:CO
Practice Address - Zip Code:81650-4717
Practice Address - Country:US
Practice Address - Phone:970-945-2840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-23
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA84651223G0001X
CODEN.00205467122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice