Individual
DR. CHARLES KEITH RAYNOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3000 SW 148TH AVE, MIRAMAR, FL 33027-4169
(954) 450-4533
(954) 450-4834
Mailing address
3000 SW 148TH AVE, MIRAMAR, FL 33027-4169
(954) 450-4533
(954) 450-4834
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN0014927
FL
Other
Enumeration date
07/19/2007
Last updated
07/19/2007
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