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Individual

AUDRA RAUH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1905 W SPRINGFIELD AVE, CHAMPAIGN, IL 61821-3007
(217) 355-6396
Mailing address
7703 FLOYD CURL DR, SAN ANTONIO, TX 78229-3901
(806) 626-2697

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.034680
IL
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
03/20/2023
Last updated
11/01/2023
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