Provider Demographics
NPI:1184624538
Name:AUST, DONALD PHILIP (DDS)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:PHILIP
Last Name:AUST
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 1:790 WELLINGTON AVE
Mailing Address - Street 2:STE 206
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-6126
Mailing Address - Country:US
Mailing Address - Phone:970-243-9292
Mailing Address - Fax:970-243-2168
Practice Address - Street 1:790 WELLINGTON AVE
Practice Address - Street 2:STE 206
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-6126
Practice Address - Country:US
Practice Address - Phone:970-243-9292
Practice Address - Fax:970-243-2168
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO31223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice