Provider Demographics
NPI:1932776655
Name:THUM, AARON JAMES (DMD)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:JAMES
Last Name:THUM
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 1:334 NEW SALEM DR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:IL
Mailing Address - Zip Code:61520-1058
Mailing Address - Country:US
Mailing Address - Phone:309-357-1488
Mailing Address - Fax:
Practice Address - Street 1:336 N MAIN ST
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:IL
Practice Address - Zip Code:61520-1826
Practice Address - Country:US
Practice Address - Phone:309-647-3331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-10
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.033177122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist