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General NPI Number Information
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NPI Number | 1073503991
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Entity Type | Individual
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Provider Name | GEORGE FREDERICK RAYMOND III D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 10/22/2005
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 345 E. 24TH ST.
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City | N.Y.
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State | NY
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Zip | 10010
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Country | US
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Telephone | 212-998-9800
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Fax | 212-998-9801
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Provider Business Mailing Address
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Address Line | 289 E 149TH ST 2ND FLOOR
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City | BRONX
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State | NY
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Zip | 10451-5601
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Country | US
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Telephone | 718-742-7400
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Fax | 914-243-5821
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 050432
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License Number State | NY
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