Provider Demographics
NPI:1083743744
Name:MCAUSLAN, DAVID N (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:N
Last Name:MCAUSLAN
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 1:39W439 WOODGATE RD
Mailing Address - Street 2:
Mailing Address - City:ST CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60175-7725
Mailing Address - Country:US
Mailing Address - Phone:630-584-1312
Mailing Address - Fax:630-553-9404
Practice Address - Street 1:604 CENTER PKWY
Practice Address - Street 2:SUITE B
Practice Address - City:YORKVILLE
Practice Address - State:IL
Practice Address - Zip Code:60560-1690
Practice Address - Country:US
Practice Address - Phone:630-553-9388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice