Provider Demographics
NPI:1376890814
Name:DENTISTRY WITH A TOUCH OF ART
Entity Type:Organization
Organization Name:DENTISTRY WITH A TOUCH OF ART
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:RAWA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:724-539-7781
Mailing Address - Street 1:10A LIBERTY LN
Mailing Address - Street 2:
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650-2772
Mailing Address - Country:US
Mailing Address - Phone:724-539-7781
Mailing Address - Fax:724-539-5551
Practice Address - Street 1:10A LIBERTY LN
Practice Address - Street 2:
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650
Practice Address - Country:US
Practice Address - Phone:724-539-7781
Practice Address - Fax:724-539-5551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-14
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS035480122300000X
332B00000X, 332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
No122300000XDental ProvidersDentistGroup - Single Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment