Provider Demographics
NPI:1598981987
Name:RAGER, LES R (DDS)
Entity Type:Individual
Prefix:DR
First Name:LES
Middle Name:R
Last Name:RAGER
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:PO BOX 20307
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30325
Mailing Address - Country:US
Mailing Address - Phone:404-355-6770
Mailing Address - Fax:404-355-7364
Practice Address - Street 1:1957 HOWELL MILL RD NW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30318-2522
Practice Address - Country:US
Practice Address - Phone:404-355-6770
Practice Address - Fax:404-355-7364
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA8076122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist