Provider Demographics
NPI:1326335910
Name:RAINES, JASON S (DDS)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:S
Last Name:RAINES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 BURTON LN STE 200
Mailing Address - Street 2:
Mailing Address - City:MULLICA HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08062-9441
Mailing Address - Country:US
Mailing Address - Phone:856-343-4020
Mailing Address - Fax:
Practice Address - Street 1:4 BURTON LN STE 200
Practice Address - Street 2:
Practice Address - City:MULLICA HILL
Practice Address - State:NJ
Practice Address - Zip Code:08062-9441
Practice Address - Country:US
Practice Address - Phone:856-343-4020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-01
Last Update Date:2023-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DIO25005011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice