MEDICARE: AUBURN DENTAL ASSOCIATES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	7380	IN

General Provider Information

NPI Number	:	1962508580
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AUBURN DENTAL ASSOCIATES

Provider Business Mailing Address
First Line	:	1100 N MAIN STREET
Second Line	:	SUITE 101
City	:	AUBURN
State	:	IN
Zip	:	46706-1200
Country	:	US
Telephone Number	:	260-925-3110
Fax Number	:	260-925-5690

Provider Business Practice Location Address
First Line	:	1100 N MAIN STREET
Second Line	:	SUITE 101
City	:	AUBURN
State	:	IN
Zip	:	46706-1200
Country	:	US
Telephone Number	:	260-925-3110
Fax Number	:	260-925-5690

Authorized Official
Title or Position	:	DOCTOR VICE PRESIDENT
Name	:	ANDREW CHRISTIAN SCHMIDT
Credential	:	DDS
Telephone Number	:	260-925-5690

Provider Enumeration Date	:	09/15/2006
Last Update Date	:	08/22/2020

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