Provider Demographics
NPI:1316193451
Name:RICHARD R. RAUKTIS
Entity Type:Organization
Organization Name:RICHARD R. RAUKTIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:R
Authorized Official - Last Name:RAUKTIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:610-253-4343
Mailing Address - Street 1:2710 WILLIAM PENN HWY
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-5268
Mailing Address - Country:US
Mailing Address - Phone:610-253-4343
Mailing Address - Fax:
Practice Address - Street 1:2710 WILLIAM PENN HWY
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18045-5268
Practice Address - Country:US
Practice Address - Phone:610-253-4343
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-08
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS019377L122300000X
PADS035546122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty