Provider Demographics
NPI:1366448524
Name:RAFFERTY, LINDA PATRICIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:PATRICIA
Last Name:RAFFERTY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:9622 ENDSLEIGH CT
Mailing Address - Street 2:
Mailing Address - City:GRANITE BAY
Mailing Address - State:CA
Mailing Address - Zip Code:95746-6648
Mailing Address - Country:US
Mailing Address - Phone:916-782-7233
Mailing Address - Fax:916-782-7197
Practice Address - Street 1:2520 DOUGLAS BLVD
Practice Address - Street 2:STE 130
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3993
Practice Address - Country:US
Practice Address - Phone:916-782-2278
Practice Address - Fax:916-782-2270
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-22
Last Update Date:2011-05-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA377261223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry