Provider Demographics
NPI:1841744455
Name:RAFFENSPERGER, ZACHARY D (DMD)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:D
Last Name:RAFFENSPERGER
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 1:115 CRESTVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HOLLAND
Mailing Address - State:PA
Mailing Address - Zip Code:17557-1523
Mailing Address - Country:US
Mailing Address - Phone:717-475-2848
Mailing Address - Fax:
Practice Address - Street 1:5500 CORPORATE DR STE 310
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-5886
Practice Address - Country:US
Practice Address - Phone:412-219-9609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-11
Last Update Date:2019-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0408561223G0001X, 1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
No1223G0001XDental ProvidersDentistGeneral Practice