Provider Demographics
NPI:1245378710
Name:R.R.RAJ D.D.S. P.A.
Entity Type:Organization
Organization Name:R.R.RAJ D.D.S. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:R
Authorized Official - Middle Name:R
Authorized Official - Last Name:RAJ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:904-764-3844
Mailing Address - Street 1:9343 LEM TURNER RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32208-2274
Mailing Address - Country:US
Mailing Address - Phone:904-764-3844
Mailing Address - Fax:904-765-3839
Practice Address - Street 1:9343 LEM TURNER RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32208-2274
Practice Address - Country:US
Practice Address - Phone:904-764-3844
Practice Address - Fax:904-765-3839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL109601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty