Provider Demographics
NPI:1164726873
Name:CHRISTOPHER A RAWLE DMD MS PA
Entity Type:Organization
Organization Name:CHRISTOPHER A RAWLE DMD MS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:A
Authorized Official - Last Name:RAWLE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD MS
Authorized Official - Phone:407-682-1818
Mailing Address - Street 1:903 N STATE ROAD 434
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-7026
Mailing Address - Country:US
Mailing Address - Phone:407-682-1818
Mailing Address - Fax:407-682-2504
Practice Address - Street 1:903 N STATE ROAD 434
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-7026
Practice Address - Country:US
Practice Address - Phone:407-682-1818
Practice Address - Fax:407-682-2504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-10
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN189121223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty