Provider Demographics
NPI:1376617670
Name:DENTAL ARTS OF OCEANSIDE
Entity Type:Organization
Organization Name:DENTAL ARTS OF OCEANSIDE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:RAFF
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:516-678-4500
Mailing Address - Street 1:3089 LAWSON BLVD
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572
Mailing Address - Country:US
Mailing Address - Phone:516-678-4500
Mailing Address - Fax:516-763-2769
Practice Address - Street 1:3089 LAWSON BLVD
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572
Practice Address - Country:US
Practice Address - Phone:516-678-4500
Practice Address - Fax:516-763-2769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty