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General NPI Number Information
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NPI Number | 1194996231
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Entity Type | Organization
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Legal Business Name | RAGLAND PROFESSIONAL DENTAL CORPORATION
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Dates
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Enumeration Date | 03/17/2008
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Last Update Date | 03/17/2008
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Provider Practice Location Address
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Address Line | 1820 AVONDALE AVE STE 4
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City | SACRAMENTO
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State | CA
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Zip | 95825-1394
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Country | US
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Telephone | 916-972-9133
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Fax | 916-367-6725
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Provider Business Mailing Address
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Address Line | 1820 AVONDALE AVE STE 4
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City | SACRAMENTO
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State | CA
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Zip | 95825-1394
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Country | US
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Telephone | 916-972-9133
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Fax | 916-367-6725
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Authorized Official
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Title or Position | OWNER
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Name | DR. DARRYL KEVIN RAGLAND
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Credential | DDS
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Telephone | 916-972-9133
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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