Provider Demographics
NPI:1669519781
Name:AUCH, COREY J (DDS)
Entity type:Individual
Prefix:
First Name:COREY
Middle Name:J
Last Name:AUCH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:13215 BIRCH DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68164-5431
Mailing Address - Country:US
Mailing Address - Phone:402-390-0770
Mailing Address - Fax:402-390-1074
Practice Address - Street 1:13215 BIRCH DR
Practice Address - Street 2:SUITE 100
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68164-5431
Practice Address - Country:US
Practice Address - Phone:402-390-0770
Practice Address - Fax:402-390-1074
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE64261223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery