Provider Demographics
NPI:1417042599
Name:AUMILLER, JOHN TRENT (DDS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:TRENT
Last Name:AUMILLER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1711 LYNNCREST RD
Mailing Address - Street 2:
Mailing Address - City:TIMONIUM
Mailing Address - State:MD
Mailing Address - Zip Code:21093-5744
Mailing Address - Country:US
Mailing Address - Phone:410-825-6222
Mailing Address - Fax:410-825-4612
Practice Address - Street 1:8400 BELLONA LN
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2024
Practice Address - Country:US
Practice Address - Phone:410-825-6222
Practice Address - Fax:410-825-4612
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD51711223G0001X
TX102451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice