Organization
RAINGE FAMILY DENTAL, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LOUVENIA ANNETTE RAINGE D.M.D. (CEO)
(706) 790-4060
Entity
Organization
Contact information
Practice address
2139 LUMPKIN RD, AUGUSTA, GA 30906-3594
(706) 790-4060
(706) 790-0762
Mailing address
2139 LUMPKIN RD, AUGUSTA, GA 30906-3594
(706) 790-4060
(706) 790-0762
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10923
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000433925A
—
GA
01
—
112037
DORAL DENTAL
GA
01
—
746828
UNITED CONCORDIA
GA
Enumeration date
06/01/2008
Last updated
08/13/2012
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