Provider Demographics
NPI:1114098225
Name:RAYNE, MARGARET ELIZABETH (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:ELIZABETH
Last Name:RAYNE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 W BEN WHITE BLVD
Mailing Address - Street 2:SUITE 112A
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-6888
Mailing Address - Country:US
Mailing Address - Phone:512-443-5813
Mailing Address - Fax:512-443-5904
Practice Address - Street 1:1221 W BEN WHITE BLVD
Practice Address - Street 2:SUITE 112A
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-6888
Practice Address - Country:US
Practice Address - Phone:512-443-5813
Practice Address - Fax:512-443-5904
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-11
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX149801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice