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General NPI Number Information
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NPI Number | 1336703057
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Entity Type | Organization
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Legal Business Name | BRACES BY ABBADENT, LLC
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Dates
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Enumeration Date | 04/29/2019
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Last Update Date | 04/29/2019
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Provider Practice Location Address
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Address Line | 3430 DODGE ST. SUITE 19
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City | DUBUQUE
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State | IA
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Zip | 52003
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Country | US
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Telephone | 563-580-2564
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Fax |
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Provider Business Mailing Address
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Address Line | 3430 DODGE ST. SUITE 19
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City | DUBUQUE
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State | IA
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Zip | 52003
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Country | US
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Telephone | 563-580-2564
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AARON JAMES RAUEN
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Credential | D.D.S.
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Telephone | 563-556-8388
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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