Provider Demographics
NPI:1477028769
Name:RAGAN DENTAL ENTERPRISES
Entity Type:Organization
Organization Name:RAGAN DENTAL ENTERPRISES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:G
Authorized Official - Last Name:LOTA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:201-788-2607
Mailing Address - Street 1:296 OLDWOODS RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07417-1114
Mailing Address - Country:US
Mailing Address - Phone:201-788-2607
Mailing Address - Fax:
Practice Address - Street 1:1465 ROUTE 31 SOUTH
Practice Address - Street 2:SUITE 29
Practice Address - City:ANNANDALE
Practice Address - State:NJ
Practice Address - Zip Code:08801
Practice Address - Country:US
Practice Address - Phone:908-730-7565
Practice Address - Fax:908-730-7965
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RAGAN DENTAL ENTERPRISES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-10-12
Last Update Date:2018-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty