Provider Demographics
NPI:1568580561
Name:RAGO, STEVEN EDWARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:EDWARD
Last Name:RAGO
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 1:35525 GARFIELD RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48035-5521
Mailing Address - Country:US
Mailing Address - Phone:586-792-4550
Mailing Address - Fax:586-792-3863
Practice Address - Street 1:35525 GARFIELD RD
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48035-5521
Practice Address - Country:US
Practice Address - Phone:586-792-4550
Practice Address - Fax:586-792-3863
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901015652122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist