Provider Demographics
NPI:1356634893
Name:DR RAFFAELLA DMD INC
Entity Type:Organization
Organization Name:DR RAFFAELLA DMD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAFFAELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARMSTRONG
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:305-371-6064
Mailing Address - Street 1:150 SE 2ND AVE
Mailing Address - Street 2:604
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33131-1518
Mailing Address - Country:US
Mailing Address - Phone:305-371-6064
Mailing Address - Fax:305-371-6068
Practice Address - Street 1:150 SE 2ND AVE
Practice Address - Street 2:604
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33131-1518
Practice Address - Country:US
Practice Address - Phone:305-371-6064
Practice Address - Fax:305-371-6068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-17
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN162691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty