Healthcare Provider Details

I. General information

NPI: 1033294483
Provider Name (Legal Business Name): RASENBERGER, VANKESTEREN & GETZ, DDS, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 07/21/2022
Certification Date: 10/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2315 W ARBORS DR STE 100
CHARLOTTE NC
28262-2660
US

IV. Provider business mailing address

2315 W ARBORS DR STE 100
CHARLOTTE NC
28262-2660
US

V. Phone/Fax

Practice location:
  • Phone: 704-549-4991
  • Fax: 704-549-0135
Mailing address:
  • Phone: 704-549-4991
  • Fax: 704-549-0135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number
License Number State

VIII. Authorized Official

Name: MR. KENNETH P RASENBERGER
Title or Position: OWNER / DENTIST
Credential: DMD
Phone: 704-549-4991