Provider Demographics
NPI:1700862125
Name:EGGERT, RAYMOND L III (DDS)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:L
Last Name:EGGERT
Suffix:III
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 1:1945 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-4221
Mailing Address - Country:US
Mailing Address - Phone:518-456-8252
Mailing Address - Fax:
Practice Address - Street 1:1945 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-4221
Practice Address - Country:US
Practice Address - Phone:518-456-8252
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0390341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice