Provider Demographics
NPI:1063295046
Name:AUBURN SMILES LLC
Entity type:Organization
Organization Name:AUBURN SMILES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILL
Authorized Official - Middle Name:
Authorized Official - Last Name:GUDENRATH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:402-274-3709
Mailing Address - Street 1:2115 14TH ST
Mailing Address - Street 2:SU #200
Mailing Address - City:AUBURN
Mailing Address - State:NE
Mailing Address - Zip Code:68305
Mailing Address - Country:US
Mailing Address - Phone:402-274-3709
Mailing Address - Fax:402-274-4230
Practice Address - Street 1:2115 14TH ST
Practice Address - Street 2:SU #200
Practice Address - City:AUBURN
Practice Address - State:NE
Practice Address - Zip Code:68305
Practice Address - Country:US
Practice Address - Phone:402-274-3709
Practice Address - Fax:402-274-4230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-15
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty