Organization
RAINES DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON RAINES (OWNER)
(908) 770-1506
Entity
Organization
Contact information
Practice address
4 BURTON LN, SUITE 200, MULLICA HILL, NJ 08062-9422
(908) 770-1506
Mailing address
1328 GREENE LN, CHERRY HILL, NJ 08003-1146
(908) 770-1506
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22DI02500500
NJ
Other
Enumeration date
07/06/2015
Last updated
07/06/2015
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