Provider Demographics
NPI:1174840284
Name:PITTS, AARON BRIAN (DMD)
Entity type:Individual
Prefix:DR
First Name:AARON
Middle Name:BRIAN
Last Name:PITTS
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:PO BOX 839
Mailing Address - Street 2:28914 OLD HWY 80 SUITE 104
Mailing Address - City:PINE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91962
Mailing Address - Country:US
Mailing Address - Phone:619-473-8735
Mailing Address - Fax:619-473-8625
Practice Address - Street 1:28914 OLD HWY 80
Practice Address - Street 2:SUITE 104
Practice Address - City:PINE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91962
Practice Address - Country:US
Practice Address - Phone:619-473-8735
Practice Address - Fax:619-473-8625
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-28
Last Update Date:2022-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39020000X390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program