Provider Demographics
NPI:1164460689
Name:RASBURY, DON M (DMD)
Entity Type:Individual
Prefix:
First Name:DON
Middle Name:M
Last Name:RASBURY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:230 E 10TH ST STE 106
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36207-5771
Mailing Address - Country:US
Mailing Address - Phone:256-741-7340
Mailing Address - Fax:256-741-1234
Practice Address - Street 1:230 E 10TH ST STE 106
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207-5771
Practice Address - Country:US
Practice Address - Phone:256-741-7340
Practice Address - Fax:256-741-1234
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL36211223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051097772OtherBCBS OF ALABAMA
AL008203980Medicaid
AL051097772OtherBCBS OF ALABAMA