Provider Demographics
NPI:1922318112
Name:LOUIS K. RAFETTO, D.M.D., P.A.
Entity Type:Organization
Organization Name:LOUIS K. RAFETTO, D.M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:K
Authorized Official - Last Name:RAFETTO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:302-477-1800
Mailing Address - Street 1:3512 SILVERSIDE RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-4941
Mailing Address - Country:US
Mailing Address - Phone:302-477-1800
Mailing Address - Fax:302-477-0343
Practice Address - Street 1:3512 SILVERSIDE RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-4941
Practice Address - Country:US
Practice Address - Phone:302-477-1800
Practice Address - Fax:302-477-0343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-21
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEG10000865204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial SurgeryGroup - Single Specialty