Healthcare Provider Details

I. General information

NPI: 1710291265
Provider Name (Legal Business Name): AUZINS WARRENTON LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2010
Last Update Date: 07/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 N HIGHWAY 101 STE C
WARRENTON OR
97146-9313
US

IV. Provider business mailing address

1725 SAINT HELENS ST
SAINT HELENS OR
97051-1744
US

V. Phone/Fax

Practice location:
  • Phone: 503-861-9421
  • Fax: 503-366-4281
Mailing address:
  • Phone: 503-366-4248
  • Fax: 503-366-4281

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberD8996
License Number StateOR

VIII. Authorized Official

Name: NORMUND K AUZINS
Title or Position: OWNER
Credential: DDS
Phone: 503-861-9421