Provider Demographics
NPI:1689027575
Name:MATT RAFIE DDS PS
Entity Type:Organization
Organization Name:MATT RAFIE DDS PS
Other - Org Name:A TO Z DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MATT
Authorized Official - Middle Name:M
Authorized Official - Last Name:RAFIE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:425-449-8570
Mailing Address - Street 1:12453 BEL RED RD
Mailing Address - Street 2:#200
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-2544
Mailing Address - Country:US
Mailing Address - Phone:425-449-8570
Mailing Address - Fax:
Practice Address - Street 1:12453 BEL RED RD
Practice Address - Street 2:#200
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2544
Practice Address - Country:US
Practice Address - Phone:425-449-8570
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-15
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00011101261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental