Provider Demographics
NPI:1578738845
Name:ALAN RASKAS DDS PA
Entity Type:Organization
Organization Name:ALAN RASKAS DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ARMSTRONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-424-3335
Mailing Address - Street 1:2 SPLIT ROCK DR
Mailing Address - Street 2:SUITE 10
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-1244
Mailing Address - Country:US
Mailing Address - Phone:856-424-3335
Mailing Address - Fax:856-424-8753
Practice Address - Street 1:2 SPLIT ROCK DR
Practice Address - Street 2:SUITE 10
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-1244
Practice Address - Country:US
Practice Address - Phone:856-424-3335
Practice Address - Fax:856-424-8753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-28
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI008741001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty