Healthcare Provider Details

I. General information

NPI: 1073224887
Provider Name (Legal Business Name): AERO DENTAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2022
Last Update Date: 12/13/2022
Certification Date: 12/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1209 WARD AVE
WEST CHESTER PA
19380-4200
US

IV. Provider business mailing address

401 COMMERCE DR STE 108
FORT WASHINGTON PA
19034-2724
US

V. Phone/Fax

Practice location:
  • Phone: 610-998-6310
  • Fax: 215-825-8191
Mailing address:
  • Phone: 215-550-4590
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. LEILA MAKI
Title or Position: OWNER
Credential:
Phone: 215-550-4590