| Organization Name: | DAVID N MCAUSLAN DDS PC |
| NPI Number: | 1215377031 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DAVID N MCAUSLAN (OWNER/ DENTIST) |
| Mailing Address: | 619 E Main St Genoa |
| State: | IL US |
| Postal Code: | 601351309 |
| Phone Number: | 8157845166 |
| Fax Number: | 8157845167 |
| NPI Enumeration Date: | 06/25/2013 |
| NPI Last Update Date: | 06/25/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | 019017239 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |