Provider Demographics
NPI:1780746586
Name:PRYOR, AARON EUGENE (DDS)
Entity type:Individual
Prefix:DR
First Name:AARON
Middle Name:EUGENE
Last Name:PRYOR
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 1:201 SIGNATURE PL
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087-3282
Mailing Address - Country:US
Mailing Address - Phone:615-444-7999
Mailing Address - Fax:
Practice Address - Street 1:201 SIGNATURE PL
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-3282
Practice Address - Country:US
Practice Address - Phone:615-444-7999
Practice Address - Fax:615-444-7919
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN80641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1840427OtherUNITED CONCORDIA