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Individual

DR. MARCIA L. AULD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.M.D.

Contact information

Practice address
285 N. WESTGATE AVE., JACKSONVILLE, IL 62650-1700
(217) 245-4012
Mailing address
285 N. WESTGATE AVE., JACKSONVILLE, IL 62650-1700
(217) 245-4012

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
15800
BCBS
IL
01
DNIL16856A
BCBS
IL
Enumeration date
10/03/2006
Last updated
04/08/2008
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