Provider Demographics
NPI:1770743387
Name:AUBLE, MARK ROBERT (DDS, MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:ROBERT
Last Name:AUBLE
Suffix:
Gender:M
Credentials:DDS, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1996 ROCKY MOUNTAIN AVE
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-8647
Mailing Address - Country:US
Mailing Address - Phone:970-669-4802
Mailing Address - Fax:970-669-9232
Practice Address - Street 1:1996 ROCKY MOUNTAIN AVE
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-8647
Practice Address - Country:US
Practice Address - Phone:970-669-4802
Practice Address - Fax:970-669-9232
Is Sole Proprietor?:No
Enumeration Date:2008-06-17
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-037905122300000X
NE6755122300000X
CODR.0055864208600000X
CODEN.00202539204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
No122300000XDental ProvidersDentist
No208600000XAllopathic & Osteopathic PhysiciansSurgery