Provider Demographics
NPI:1508389230
Name:BAUNE, WILLIAM DONALD (DDS)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:DONALD
Last Name:BAUNE
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 1:11423 LAKE RD
Mailing Address - Street 2:
Mailing Address - City:ROSHOLT
Mailing Address - State:SD
Mailing Address - Zip Code:57260-7106
Mailing Address - Country:US
Mailing Address - Phone:605-268-3606
Mailing Address - Fax:
Practice Address - Street 1:11423 LAKE ROAD
Practice Address - Street 2:
Practice Address - City:ROSHOLT
Practice Address - State:SD
Practice Address - Zip Code:57260
Practice Address - Country:US
Practice Address - Phone:605-268-3606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDD1152122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist