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Organization
RAPHAELSON DENTAL ASSOCIATES LLP
Active
Organization
RAPHAELSON DENTAL ASSOCIATES LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TODD F RAPHAELSON DDS (OWNER DENTIST)
(631) 667-4080
Entity
Organization
Contact information
Practice address
450 GRAND BLVD, DEER PARK, NY 11729-4286
(631) 667-4080
(631) 667-4261
Mailing address
450 GRAND BLVD, DEER PARK, NY 11729-4286
(631) 667-4080
(631) 667-4261
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
045415
NY
122300000X
Dentist
047488
NY
122300000X
Dentist
050227
NY
Other
Enumeration date
11/30/2006
Last updated
09/14/2012
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