Provider Demographics
NPI:1982236790
Name:OAKWOOD DENTAL PLLC
Entity Type:Organization
Organization Name:OAKWOOD DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:W
Authorized Official - Last Name:RAKECKY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:313-929-5360
Mailing Address - Street 1:18181 OAKWOOD BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-4082
Mailing Address - Country:US
Mailing Address - Phone:313-563-3300
Mailing Address - Fax:
Practice Address - Street 1:18181 OAKWOOD BLVD STE 103
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-4082
Practice Address - Country:US
Practice Address - Phone:313-563-3300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-10
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental