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Individual

DR. ERIC BRUCE RACHA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
120 MEMORIAL PARKWAY, UTICA, NY 13501
(315) 733-5722
(315) 733-9472
Mailing address
120 MEMORIAL PARKWAY, UTICA, NY 13501
(315) 733-5722
(315) 733-9472

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0421711
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
011218
FIDELIS
NY
05
01805949
NY
Enumeration date
11/14/2006
Last updated
07/08/2007
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