Provider Demographics
NPI:1255490553
Name:RAXENBERG, FRANCINE PAULA (DDS)
Entity Type:Individual
Prefix:DR
First Name:FRANCINE
Middle Name:PAULA
Last Name:RAXENBERG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 JOYCE LN
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11797-2124
Mailing Address - Country:US
Mailing Address - Phone:516-921-4858
Mailing Address - Fax:516-802-0475
Practice Address - Street 1:590 JERICHO TPKE FL 2
Practice Address - Street 2:
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791
Practice Address - Country:US
Practice Address - Phone:516-433-2211
Practice Address - Fax:516-681-2562
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0379421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice