Provider Demographics
NPI:1891815189
Name:RAGLAND, JEFFREY CHARLES (DMD MS)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:CHARLES
Last Name:RAGLAND
Suffix:
Gender:M
Credentials:DMD MS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:800 EDGEWOOD ROAD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402
Mailing Address - Country:US
Mailing Address - Phone:717-755-0422
Mailing Address - Fax:717-755-0111
Practice Address - Street 1:800 EDGEWOOD ROAD
Practice Address - Street 2:SUITE 1
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402
Practice Address - Country:US
Practice Address - Phone:717-755-0422
Practice Address - Fax:717-755-0111
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS030568L1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics