Provider Demographics
NPI:1003500398
Name:AUNGST, MADISON (DDS)
Entity Type:Individual
Prefix:
First Name:MADISON
Middle Name:
Last Name:AUNGST
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 FIORE LN
Mailing Address - Street 2:
Mailing Address - City:HOLLIDAYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16648-9667
Mailing Address - Country:US
Mailing Address - Phone:814-515-0262
Mailing Address - Fax:
Practice Address - Street 1:4579 E PLEASANT VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:TYRONE
Practice Address - State:PA
Practice Address - Zip Code:16686-7032
Practice Address - Country:US
Practice Address - Phone:814-684-9455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-08
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0441101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice