Provider Demographics
NPI:1700042546
Name:MAAS, RANAE M (RDH, DT)
Entity Type:Individual
Prefix:MS
First Name:RANAE
Middle Name:M
Last Name:MAAS
Suffix:
Gender:F
Credentials:RDH, DT
Other - Prefix:
Other - First Name:RANAE
Other - Middle Name:
Other - Last Name:MAAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDH, DT
Mailing Address - Street 1:2304 INDIAN WAY
Mailing Address - Street 2:
Mailing Address - City:NORTH SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55109-1510
Mailing Address - Country:US
Mailing Address - Phone:651-600-2808
Mailing Address - Fax:
Practice Address - Street 1:478 ROBERT ST S
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55107-2236
Practice Address - Country:US
Practice Address - Phone:651-602-7575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-31
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT857124Q00000X
MNH6057124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist