# KENNETH J RASBORNIK, DMD PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194023481
- **Authorized official:** MR. KENNETH JAMES RASBORNIK DMD, PA (OWNER/DOCTOR)
- **Authorized official phone:** (704) 278-1118

## Contact information

- **Practice address:** 11707 STATESVILLE BLVD, CLEVELAND, NC 27013-9418
- **Practice address phone:** (704) 278-1118
- **Practice address fax:** (704) 278-4480
- **Mailing address:** 11707 STATESVILLE BLVD, CLEVELAND, NC 27013-9418
- **Mailing address phone:** (704) 278-1118
- **Mailing address fax:** (704) 278-4480

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 6374 | NC | Yes |

## Other

- **Enumeration date:** 03/10/2011
- **Last updated:** 03/10/2011