Provider Demographics
NPI:1851305643
Name:PETE J. RAUEN D.M.D., INC.
Entity Type:Organization
Organization Name:PETE J. RAUEN D.M.D., INC.
Other - Org Name:CRESTVIEW HILLS DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:RAUEN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:859-331-8880
Mailing Address - Street 1:232 THOMAS MORE PKWY
Mailing Address - Street 2:
Mailing Address - City:CRESTVIEW HILLS
Mailing Address - State:KY
Mailing Address - Zip Code:41017-3424
Mailing Address - Country:US
Mailing Address - Phone:859-331-8880
Mailing Address - Fax:859-331-7550
Practice Address - Street 1:232 THOMAS MORE PKWY
Practice Address - Street 2:
Practice Address - City:CRESTVIEW HILLS
Practice Address - State:KY
Practice Address - Zip Code:41017-3424
Practice Address - Country:US
Practice Address - Phone:859-331-8880
Practice Address - Fax:859-331-7550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5650122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty