Organization
FRED J. RAVENS III DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FRED J RAVENS III DDS (OWNER)
(781) 944-0464
Entity
Organization
Contact information
Practice address
198 ASH ST, READING, MA 01867-3623
(781) 944-0464
Mailing address
198 ASH ST, READING, MA 01867-3623
(781) 944-0464
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
13948
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
X05118
BLUE CROSS BLUE SHEILD
MA
Enumeration date
05/06/2008
Last updated
05/06/2008
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