Provider Demographics
NPI:1780001362
Name:WILLIAM J AUD DMD INC
Entity Type:Organization
Organization Name:WILLIAM J AUD DMD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:AUD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:270-683-4122
Mailing Address - Street 1:922 TRIPLETT ST STE 9
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-3118
Mailing Address - Country:US
Mailing Address - Phone:270-683-4122
Mailing Address - Fax:
Practice Address - Street 1:922 TRIPLETT ST STE 9
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-3118
Practice Address - Country:US
Practice Address - Phone:270-683-4122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-21
Last Update Date:2014-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5441261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental