Provider Demographics
NPI:1790798478
Name:PARA, RAYMOND L (DDS)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:L
Last Name:PARA
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 1:720 YORKLYN RD
Mailing Address - Street 2:STE 120
Mailing Address - City:HOCKESSIN
Mailing Address - State:DE
Mailing Address - Zip Code:19707-8730
Mailing Address - Country:US
Mailing Address - Phone:302-234-2728
Mailing Address - Fax:302-234-3326
Practice Address - Street 1:720 YORKLYN RD
Practice Address - Street 2:STE 120
Practice Address - City:HOCKESSIN
Practice Address - State:DE
Practice Address - Zip Code:19707-8730
Practice Address - Country:US
Practice Address - Phone:302-234-2728
Practice Address - Fax:302-234-3326
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2009-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEG100009551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE51-0395407Medicare UPIN