Healthcare Provider Details

I. General information

NPI: 1710072368
Provider Name (Legal Business Name): ARTHUR RAHN D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

VA MEDICAL CENTER 1FREEDOM WAY
AUGUSTA GA
30904
US

IV. Provider business mailing address

VA MEDICAL CENTER 1FREEDOM WAY
AUGUSTA GA
30904
US

V. Phone/Fax

Practice location:
  • Phone: 706-733-0188
  • Fax:
Mailing address:
  • Phone: 706-733-0188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number8797
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: