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General NPI Number Information
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NPI Number | 1538265822
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Entity Type | Organization
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Legal Business Name | SERGIO M. RAUCHWERGER DMD PL
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Dates
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Enumeration Date | 09/15/2006
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Last Update Date | 01/06/2009
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Provider Practice Location Address
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Address Line | 3975 ISLES VIEW DR SUITE 202
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City | WELLINGTON
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State | FL
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Zip | 33414-8854
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Country | US
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Telephone | 561-798-7807
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Fax | 561-422-3276
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Provider Business Mailing Address
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Address Line | 3975 ISLES VIEW DR SUITE 202
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City | WELLINGTON
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State | FL
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Zip | 33414-8854
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Country | US
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Telephone | 561-798-7807
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Fax | 561-422-3276
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SERGIO RAUCHWERGER
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Credential | D.M.D.
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Telephone | 561-798-7807
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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 |
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License Number State |
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