Provider Demographics
NPI:1235494758
Name:RAINI A. SPITZE DDS, PC
Entity Type:Organization
Organization Name:RAINI A. SPITZE DDS, PC
Other - Org Name:REDLAND FAMILY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAINI
Authorized Official - Middle Name:
Authorized Official - Last Name:SPITZE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:503-631-2353
Mailing Address - Street 1:18221 S REDLAND RD
Mailing Address - Street 2:
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-8823
Mailing Address - Country:US
Mailing Address - Phone:503-631-2353
Mailing Address - Fax:503-631-3253
Practice Address - Street 1:18221 S REDLAND RD
Practice Address - Street 2:
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-8823
Practice Address - Country:US
Practice Address - Phone:503-631-2353
Practice Address - Fax:503-631-3253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-10
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD94241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty