Organization
IMPLANTIS ORAL & FACIAL SURGERY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY RASKA DMD (PRESIDENT)
(941) 923-0033
Entity
Organization
Contact information
Practice address
3940 SWIFT RD, SARASOTA, FL 34231-6541
(941) 923-0033
(941) 922-4621
Mailing address
3940 SWIFT RD, SARASOTA, FL 34231-6541
(941) 923-0033
(941) 922-4621
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN18583
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013920669
INDIVIDUAL NPI
FL
Enumeration date
02/24/2012
Last updated
02/24/2012
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