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General NPI Number Information
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NPI Number | 1174031264
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Entity Type | Organization
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Legal Business Name | JOHN L. AURELIA, D.D.S., PLLC
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Dates
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Enumeration Date | 01/11/2018
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Last Update Date | 08/23/2021
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Provider Practice Location Address
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Address Line | 804 N. MAIN ST SUITE 201A
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City | ROCHESTER
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State | MI
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Zip | 48307
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Country | US
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Telephone | 248-651-6810
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Fax |
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Provider Business Mailing Address
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Address Line | 804 N. MAIN ST SUITE 201A
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City | ROCHESTER
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State | MI
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Zip | 48307
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Country | US
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Telephone | 248-651-6810
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Fax | 248-651-0697
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Authorized Official
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Title or Position | OWNER
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Name | MR. JOHN LOUIS AURELIA
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Credential | DDS
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Telephone | 248-651-6810
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 2901018604
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2901018604
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License Number State | MI
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