MEDICARE: AARON PARK DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	057847	NY

General Provider Information

NPI Number	:	1073952321
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AARON PARK DDS

Provider Business Mailing Address
First Line	:	2384 MONROE AVE
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14618-3032
Country	:	US
Telephone Number	:	585-442-5500
Fax Number	:	585-442-5502

Provider Business Practice Location Address
First Line	:	2384 MONROE AVE
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14618-3032
Country	:	US
Telephone Number	:	585-442-5500
Fax Number	:	585-442-5502

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2013
Last Update Date	:	08/06/2019

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Directions to “ AARON PARK DDS” Practice Location

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