Provider Demographics
NPI:1225649585
Name:RACHOR DENTAL CARE
Entity Type:Organization
Organization Name:RACHOR DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:
Authorized Official - Last Name:TOMCZYK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-629-0601
Mailing Address - Street 1:1398 N LEROY ST
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48430-2762
Mailing Address - Country:US
Mailing Address - Phone:810-629-0601
Mailing Address - Fax:
Practice Address - Street 1:1398 N LEROY ST
Practice Address - Street 2:
Practice Address - City:FENTON
Practice Address - State:MI
Practice Address - Zip Code:48430-2762
Practice Address - Country:US
Practice Address - Phone:810-629-0601
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-11
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0001XDental ProvidersDentistDental Public HealthGroup - Single Specialty