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General NPI Number Information
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NPI Number | 1104154624
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Entity Type | Organization
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Legal Business Name | AULD FAMILY DENTISTRY PLLC
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Dates
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Enumeration Date | 11/20/2009
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Last Update Date | 04/16/2020
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Provider Practice Location Address
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Address Line | 215 N 6TH ST
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City | MCALESTER
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State | OK
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Zip | 74501-4737
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Country | US
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Telephone | 918-423-0200
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Fax | 918-423-6940
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Provider Business Mailing Address
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Address Line | 215 N 6TH ST
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City | MCALESTER
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State | OK
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Zip | 74501-4737
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Country | US
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Telephone | 918-423-0200
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Fax | 918-423-6940
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Authorized Official
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Title or Position | OWNER
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Name | DR. DOUGLAS AULD
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Credential | DDS
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Telephone | 918-423-0200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 6096
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 4337
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License Number State | OK
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