Provider Demographics
NPI:1457584872
Name:DR STEVEN RATTNER DDS, PA
Entity Type:Organization
Organization Name:DR STEVEN RATTNER DDS, PA
Other - Org Name:DR STEVEN RATTNER DDS PA AND ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:RATTNER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-474-8277
Mailing Address - Street 1:6100 WESTCHESTER PARK DR
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20740-2852
Mailing Address - Country:US
Mailing Address - Phone:301-474-8277
Mailing Address - Fax:
Practice Address - Street 1:6100 WESTCHESTER PARK DR
Practice Address - Street 2:
Practice Address - City:COLLEGE PARK
Practice Address - State:MD
Practice Address - Zip Code:20740-2852
Practice Address - Country:US
Practice Address - Phone:301-474-8277
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-02
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12318122300000X
MD78571223G0001X
MD90751223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty