Provider Demographics
NPI:1225034374
Name:AUSTIN, B PETER (DDS)
Entity Type:Individual
Prefix:
First Name:B
Middle Name:PETER
Last Name:AUSTIN
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 1:406 SCIENCE DR
Mailing Address - Street 2:STE 410
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53711-1068
Mailing Address - Country:US
Mailing Address - Phone:608-231-9989
Mailing Address - Fax:608-231-2814
Practice Address - Street 1:406 SCIENCE DR
Practice Address - Street 2:STE 410
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53711-1068
Practice Address - Country:US
Practice Address - Phone:608-231-9989
Practice Address - Fax:608-231-2814
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI38171223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics