Provider Demographics
NPI:1417111055
Name:CAINE, DONALD RAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:RAY
Last Name:CAINE
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 1:99 WINDING WAY
Mailing Address - Street 2:
Mailing Address - City:WOODCLIFF LAKE
Mailing Address - State:NJ
Mailing Address - Zip Code:07677
Mailing Address - Country:US
Mailing Address - Phone:201-391-4411
Mailing Address - Fax:201-505-1676
Practice Address - Street 1:99 WINDING WAY
Practice Address - Street 2:
Practice Address - City:WOODCLIFF LAKE
Practice Address - State:NJ
Practice Address - Zip Code:07677
Practice Address - Country:US
Practice Address - Phone:201-391-4411
Practice Address - Fax:201-505-1676
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-14
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22D100674200122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist