Organization
DOC RAIFFE MANAGEMENT GROUP LLC
Active
Other names
Tri-City Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
OPAL ANDERSON (REGIONAL MANAGER)
(440) 823-6790
Entity
Organization
Contact information
Practice address
17601 W 130TH ST, SUITE 101, NORTH ROYALTON, OH 44133-5966
(440) 582-0550
Mailing address
17601 W 130TH ST, SUITE 101, NORTH ROYALTON, OH 44133-5966
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19625
OH
Other
Enumeration date
07/28/2015
Last updated
07/28/2015
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