=====================================================
General NPI Number Information
=====================================================
NPI Number | 1063374072
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AURORA DENTAL HYGIENE, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/27/2025
-----------------------------------------------------
Last Update Date | 11/27/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 611 FRANKLIN ST MOBILE CLINIC'S HOME BASE.
-----------------------------------------------------
City | COLUMBUS
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53925-1434
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 920-626-8881
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 611 FRANKLIN ST
-----------------------------------------------------
City | COLUMBUS
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53925-1434
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 920-626-8881
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | FOUNDER/DENTAL HYGIENIST
-----------------------------------------------------
Name | VICTORIA LYNN POGUE
-----------------------------------------------------
Credential | RDH
-----------------------------------------------------
Telephone | 920-626-8881
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QD0000X
-----------------------------------------------------
Taxonomy Name | Dental Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------