Provider Demographics
NPI:1033780457
Name:BRIANNA RAFETTO DMD PA
Entity Type:Organization
Organization Name:BRIANNA RAFETTO DMD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAFETTO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:610-331-1074
Mailing Address - Street 1:600 N BROAD ST STE 7
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-1032
Mailing Address - Country:US
Mailing Address - Phone:302-376-7882
Mailing Address - Fax:
Practice Address - Street 1:600 N BROAD ST STE 7
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-1032
Practice Address - Country:US
Practice Address - Phone:302-376-7882
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-07
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty