Individual
DYLAN RACHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3301 VETERANS MEMORIAL BLVD STE 203, METAIRIE, LA 70002-8440
(504) 887-6453
Mailing address
6841 GLASS FACTORY RD, HOLLAND PATENT, NY 13354-4135
(315) 794-8576
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7292
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/09/2019
Last updated
08/09/2022
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