Provider Demographics
NPI:1063812006
Name:AAA DENTAL CORPORATION
Entity type:Organization
Organization Name:AAA DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AVINASH
Authorized Official - Middle Name:BABHU
Authorized Official - Last Name:KUTTUVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-802-2273
Mailing Address - Street 1:1 UNION ST
Mailing Address - Street 2:
Mailing Address - City:ROBBINSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08691-4219
Mailing Address - Country:US
Mailing Address - Phone:609-509-4090
Mailing Address - Fax:
Practice Address - Street 1:1 UNION ST
Practice Address - Street 2:
Practice Address - City:ROBBINSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08691-4219
Practice Address - Country:US
Practice Address - Phone:609-509-4090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-27
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ232251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty