Individual
TIMOTHY P RAUSCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
645 US HWY 61, NEW MADRID, MO 63869
(573) 748-2225
(573) 748-5655
Mailing address
PO BOX 250, 645 US HWY 61, NEW MADRID, MO 63869
(573) 748-2225
(573) 748-5655
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE-015440
MO
122300000X
Dentist
DE015440
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
403746407
—
MO
Enumeration date
12/11/2006
Last updated
02/02/2011
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