Provider Demographics
NPI:1851569230
Name:RHETT RAINS, D.D.S., P.C.
Entity Type:Organization
Organization Name:RHETT RAINS, D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RHETT
Authorized Official - Middle Name:
Authorized Official - Last Name:RAINS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:918-355-1391
Mailing Address - Street 1:2522 E KENOSHA ST
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74014-6712
Mailing Address - Country:US
Mailing Address - Phone:918-355-1391
Mailing Address - Fax:918-355-4135
Practice Address - Street 1:2522 E KENOSHA ST
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74014-6712
Practice Address - Country:US
Practice Address - Phone:918-355-1391
Practice Address - Fax:918-355-4135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-19
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK57731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty