Provider Demographics
NPI:1295014603
Name:RAUTH, RICHARD JAMES (DDS MS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:JAMES
Last Name:RAUTH
Suffix:
Gender:M
Credentials:DDS MS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1234 SEVENTH STREET
Mailing Address - Street 2:SUITE 3
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90401
Mailing Address - Country:US
Mailing Address - Phone:310-393-9733
Mailing Address - Fax:310-576-1383
Practice Address - Street 1:1234 SEVENTH STREET
Practice Address - Street 2:SUITE 3
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90401
Practice Address - Country:US
Practice Address - Phone:310-393-9733
Practice Address - Fax:310-576-1383
Is Sole Proprietor?:No
Enumeration Date:2011-08-16
Last Update Date:2011-08-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA602891223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics