Provider Demographics
NPI:1932399284
Name:WALKER, AARON S (DMD)
Entity type:Individual
Prefix:DR
First Name:AARON
Middle Name:S
Last Name:WALKER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6312 BUFORD ST
Mailing Address - Street 2:#606
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-2357
Mailing Address - Country:US
Mailing Address - Phone:317-379-7936
Mailing Address - Fax:
Practice Address - Street 1:680 E STATE ROAD 50
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-3184
Practice Address - Country:US
Practice Address - Phone:352-241-4500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-01
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12011001A122300000X
FLDN 195751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist