Provider Demographics
NPI:1982886438
Name:ERCOLE, AARON CHRISTOPHER (DDS)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:CHRISTOPHER
Last Name:ERCOLE
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 1:11823 TROIKA CT
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-6284
Mailing Address - Country:US
Mailing Address - Phone:562-833-5570
Mailing Address - Fax:
Practice Address - Street 1:468 SMITHFIELD RD
Practice Address - Street 2:
Practice Address - City:NORTH PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904-4238
Practice Address - Country:US
Practice Address - Phone:401-353-1515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-27
Last Update Date:2015-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55855122300000X
RIDEN032491223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery