Provider Demographics
NPI:1760561088
Name:RAUCHWERGER, SERGIO (DMD)
Entity Type:Individual
Prefix:
First Name:SERGIO
Middle Name:
Last Name:RAUCHWERGER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3975 ISLES VIEW DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-8854
Mailing Address - Country:US
Mailing Address - Phone:561-798-7807
Mailing Address - Fax:
Practice Address - Street 1:3975 ISLES VIEW DR
Practice Address - Street 2:SUITE 202
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-8854
Practice Address - Country:US
Practice Address - Phone:561-798-7807
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN171451223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics