Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | G1-0001053 | DE |
NPI | 1154536464 |
---|---|
Provider Name | Dr. Michael Thomas Aloe |
First Address | Dover, DE 19901-4113 |
Second Address | Dover, DE 19901-4113 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2007 |
Last Update Date | 08/07/2007 |