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General NPI Number Information
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NPI Number | 1285618025
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Entity Type | Organization
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Legal Business Name | NORTHAMPTON PEDIATRIC DENTISTRY PC
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Dates
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Enumeration Date | 12/05/2005
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Last Update Date | 07/15/2015
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Provider Practice Location Address
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Address Line | 264 ELM STREET
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City | NORTHAMPTON
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State | MA
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Zip | 01060
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Country | US
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Telephone | 413-584-7773
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Fax | 413-584-0684
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Provider Business Mailing Address
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Address Line | 264 ELM STREET
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City | NORTHAMPTON
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State | MA
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Zip | 01060
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Country | US
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Telephone | 413-584-7773
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Fax | 413-584-0684
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | AARON A. DEMAIO
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Credential | DMD
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Telephone | 413-584-7773
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DN20355
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DN1856395
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 13949
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License Number State | MA
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