Healthcare Provider Details

I. General information

NPI: 1295656312
Provider Name (Legal Business Name): DALE AUFIE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2929 BURLINGAME AVE SW
WYOMING MI
49509-2600
US

IV. Provider business mailing address

2503 WOODLAKE RD SW APT 2
WYOMING MI
49519-4710
US

V. Phone/Fax

Practice location:
  • Phone: 616-965-8333
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: