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General NPI Number Information
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NPI Number | 1538498316
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Entity Type | Individual
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Provider Name | TROY ROBERT RACKI DDS
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Gender | Male
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Dates
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Enumeration Date | 12/08/2009
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 2620 LARKSPUR LN STE P
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City | REDDING
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State | CA
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Zip | 96002-1043
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Country | US
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Telephone | 530-338-2500
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Fax | 530-338-2502
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Provider Business Mailing Address
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Address Line | PO BOX 177
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City | SHASTA LAKE
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State | CA
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Zip | 96019-0177
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Country | US
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Telephone | 530-275-1231
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Fax |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 57240
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License Number State | CA
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