Provider Demographics
NPI:1932420718
Name:RASCH ORTHODONTICS
Entity Type:Organization
Organization Name:RASCH ORTHODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:WALTER
Authorized Official - Last Name:RASCH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:262-956-6000
Mailing Address - Street 1:N35W23770 CAPITOL DR STE B
Mailing Address - Street 2:
Mailing Address - City:PEWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53072-2639
Mailing Address - Country:US
Mailing Address - Phone:262-956-6000
Mailing Address - Fax:262-691-2572
Practice Address - Street 1:N35W23770 CAPITOL DR STE B
Practice Address - Street 2:
Practice Address - City:PEWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53072-2639
Practice Address - Country:US
Practice Address - Phone:262-956-6000
Practice Address - Fax:262-691-2572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-16
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6251-151223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty