Provider Demographics
NPI:1821822818
Name:AARON C. POLK, DDS
Entity type:Organization
Organization Name:AARON C. POLK, DDS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZARITSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-590-3396
Mailing Address - Street 1:211 RUSSELL BLVD.
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75965
Mailing Address - Country:US
Mailing Address - Phone:936-564-2417
Mailing Address - Fax:
Practice Address - Street 1:211 RUSSELL BLVD.
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75965
Practice Address - Country:US
Practice Address - Phone:936-564-2417
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-30
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty