Provider Demographics
NPI:1386671931
Name:RAUK, DANIEL M (DDS)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:M
Last Name:RAUK
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 1:600 S SAINT VRAIN AVE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:ESTES PARK
Mailing Address - State:CO
Mailing Address - Zip Code:80517-5422
Mailing Address - Country:US
Mailing Address - Phone:970-586-9330
Mailing Address - Fax:970-577-0045
Practice Address - Street 1:600 S SAINT VRAIN AVE
Practice Address - Street 2:SUITE 6
Practice Address - City:ESTES PARK
Practice Address - State:CO
Practice Address - Zip Code:80517-5422
Practice Address - Country:US
Practice Address - Phone:970-586-9330
Practice Address - Fax:970-577-0045
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6090122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist