Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 8931 | KY |
Y | 1223X0400X | Orthodontists | 30.023224 | OH |
NPI | 1033421169 |
---|---|
Provider Name | Dr. Aaron Kyle Rose |
First Address | Delaware, OH 43015-1475 |
Second Address | Delaware, OH 43015 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2010 |
Last Update Date | 16/08/2018 |