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NPI Code Detail

MEDICARE: AARON MULLHOLAND D.D.S.

MEDICARE: AARON MULLHOLAND D.D.S.
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
11223G0001XGeneral Practice Dentistry019.030421IL

General Provider Information

NPI Number : 1073989125
Entity Type Code : Individual
Provider Name (Legal Business Name) : AARON MULLHOLAND D.D.S.
Provider Business Mailing Address
First Line : 350 N CLARK ST
Second Line : STE 600
City : CHICAGO
State : IL
Zip : 60654-4712
Country : US
Telephone Number : 312-274-4524
Fax Number :
Provider Business Practice Location Address
First Line : 3210 W 63RD ST
Second Line :
City : CHICAGO
State : IL
Zip : 60629-3325
Country : US
Telephone Number : 312-274-4524
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2015
Last Update Date : 08/12/2015

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