Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223S0112X | Oral and Maxillofacial Surgeon | 8608 | KY |
Y | 204E00000X | Oral & Maxillofacial Surgeon | ME 120149 | FL |
NPI | 1306001920 |
---|---|
Provider Name | Dr. Aaron C Wallender |
First Address | Pensacola, FL 32503-2407 |
Second Address | Pensacola, FL 32503-2407 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2008 |
Last Update Date | 29/06/2015 |